WOW, please read this:
“At a recent town hall meeting, a man stood up and told Representative Bob Inglis to “keep your government hands off my Medicare.” The congressman, a Republican from South Carolina, tried to explain that Medicare is already a government program — but the voter, Mr. Inglis said, “wasn’t having any of it.”
I know the good doctor Jay Parkinson has addressed this before, but I think it’s worth taking another look.
Thanks…it’s actually very simple. It doesn’t matter who pays for healthcare if doctors are incentivized to do as much as they can and the processes of delivering healthcare are such a convoluted mess with no deliverer nor payor of healthcare responsible for your health. The government could try to streamline the process of reimbursement so doctors can get paid, but then they could also one day decide to pay half as much as they currently do to physicians. This essentially makes physicians government workers and that’s too risky to devotees to social status. I didn’t pay $250K and spend 9 years of my life working my 20’s away to become a postal worker. This simply won’t fly in America. Doctors won’t go for it and there would be a massive exodus amongst physicians out of the single-payer plan and into that cash-based second-tier. We’re already seeing that. Doctors are dropping Medicare. Why? Although Medicare always pays on time (it’s a nice little streamlined process for getting paid), they pay very little. So many physicians think that getting paid on time doesn’t outweigh the sacrifice of getting paid very little.
All of these top-down reformations don’t really matter. Even the CBO says that costs will continue to rise at 8% every year with Obama’s proposed reformations.
Specialists know they can’t continue making as much money as they do. They will have to cave to something that’s not as good as they have it now, but nowhere near being a government worker. Insurance companies know that they can’t expect the average American to pay 40% of your pre-tax income toward healthcare (which will happen in 8 years even with Obama’s proposed reformations). Hospital systems know they can’t control local doctors who independently contract with them. If they try, physicians threaten to leave them for the competition. And Big Pharma knows that they can no longer make money on blockbuster drugs with their current business model (huge investments with very little chance of return). When I speak to these groups, they know exactly what I’m saying when I say they are living in a fantasy world if they believe this can and will continue.
I now say the pressure is on. The first company who can create small scale healthcare “systems” rooted in today’s technology and careful process design along the lines of mini virtual Mayo Clinics that can deliver healthcare at half the cost with marked efficiencies will win…and they’ll win big. Healthcare will be reformed through disruptions just like many of the businesses from the 20th Century have been disrupted by smaller, much more effficient companies without the baggage of the 20th Century. It’s either disruption or literally force doctors to become government workers. And last I checked, it’s a free country bound by the pursuit of life, liberty, and happiness.
Why healthcare/insurance reform matters to (me and you) in pure $$ terms
a few bullet points I’d like to hear in the media on the sheer economic necessity for healthcare/insurance
- the US economic competitive advantage is continually being sapped
- startups and small business will continue to be saddled with HUGE costs
- too many American workers are in job-lock situations ie staying on just for health insurance
- the US is only industrialized/developed country where a family can be bankrupt due to healthcare costs
How much of our medical research is being spent on creating newer, more efficient and streamlined models of healthcare delivery combined with new models of healthcare payment? How much money is being spent on creating microcosms/test markets for innovative healthcare systems on a micro-level?
As of 2009, the United States government is spending about $1 trillion annually on defense-related purposes, $80B of that is on R&D.
The military has billions upon billions to spend exploring new weapons for killing people. I’d say a heck of a lot of this money is spent on failed projects. This is how we need to think of inventing new ways to deliver healthcare in America…in the same fashion and with the same resources our government thinks of inventing new ways to kill people.
I just ran across an article titled “Skilled Immigrants on Why They are Leaving the U.S.” in BusinessWeek (via Techmeme). It is not surprising to find diminished job prospects in the U.S. as a key reason, but I was shocked to read that the wait time for a Green Card for Indian and Chinese citizens is now 10 years (that’s a decade!). That is a very long time for anybody to wait and live with the uncertainties faced by visa holders. Just entering the country when you are here on a visa can be a challenge, especially if you are coming in through a major airport. And that was true even before 9/11/2001 when I was flying frequently into JFK and BOS on a student visa.
It would be a mistake to think of this problem as a nuisance to handful of foreigners. For starters, according to this article from earlier in the year, the total number of skilled professionals (doctors, engineers, etc) waiting for a Green Card had already reached 1 million in 2006 (wonder what it is now!). More importantly though is that immigration has been a key aspect of entrepreneurial and high tech activity in the US. From the same article:
Despite the fact that they constitute only 12% of the U.S. population, immigrants have started 52% of Silicon Valley’s technology companies and contributed to more than 25% of our global patents. They make up 24% of the U.S. science and engineering workforce holding bachelor’s degrees and 47% of science and engineering workers who have PhDs. Immigrants have co-founded firms such as Google (GOOG), Intel (INTC), eBay (EBAY), and Yahoo! (YHOO).
I was very lucky, in 1997 — just as I was starting my first company — I married Susan Danziger and received a Green Card shortly thereafter. I have since become a US Citizen and as such now sincerely hope that we can achieve some kind of immigration reform that will stop this brain drain. With every one who returns because they are tired of waiting we are potentially losing a chance at the next breakthrough company (which might very well be targeting the Indian or Chinese markets!).
"This is not just about the 47 million Americans who don’t have any health insurance at all. Reform is about every American who has ever feared that they may lose their coverage, if they become too sick or lose their job or change their job.
It’s about every small business that has been forced to lay off employees or cut back on their coverage, because it became too expensive. It’s about the fact that the biggest driving force behind our federal deficit is the skyrocketing cost of Medicare and Medicaid.
So let me be clear. If we do not control these costs, we will not be able to control our deficit. If we do not reform health care, your premiums and out-of-pocket costs will continue to skyrocket.
If we don’t act, 14,000 Americans will continue to lose their health insurance every single day. These are the consequences of inaction. These are the stakes of the debate that we’re having right now.”
"Online discussions, rants, and observations are either alarming (and motivating) brand managers or fooling them into unforeseen enthrallment. But the reality is that real-time dialogue is fueling connections and perceptions in the statusphere, blogopsphere, online communities, and the social web in general. It’s this swelling tsunami of chatter that will only intensify and heighten as it forces a new genre of Social Customer Relationship Management (sCRM
). Social CRM is no longer an option. It necessitates brand involvement to proactively share answers, solve problems, establish authority, and build relationships and loyalty, one tweet, blog post, update, and “like,”
mobile data is now serious $$: “According to the CTIA, a cellular industry association, wireless data service revenues for the year 2008 rose to more than $32 billion — a 39 percent increase over 2007, when they totaled $23.2 billion. Wireless data revenues for 2008 amounted to nearly 22 percent of all wireless service revenues.”
Thanks to @jeffmignon !
- 99% of teenagers have a mobile phone and most are quite capable phones.
- No teenager that I know of regularly reads a newspaper
- Most teenagers nowadays are not regular listeners to radio
- Teenagers listen to a lot of music, mostly whilst doing something else (like travelling or using a computer).
- Most teenagers enjoy and support viral marketing, as often it creates humorous and interesting content. Teenagers see adverts on websites (pop ups, banner ads) as extremely annoying and pointless
Almost a third of ordinary Americans say human beings have existed in their current form since the beginning of time, a view held by only 2 percent of the scientists. Only about half of the public agrees that people are behind climate change, and 11 percent does not believe there is any warming at all.
According to the survey, about a third of Americans think there is lively scientific debate on both topics; in fact, there is no credible scientific challenge to the theory of evolution and there is little doubt that human activity is altering the chemistry of the atmosphere in ways that threaten global climate.
“Many independently produced films never make it onto the big screen simply because the costs involved are too high. At the moment most digital movies are distributed “over land” on hard disks costing up to $2000 for each copy. BitTorrent has the power to change this outdated distribution method and get smaller budget films onto the big screen.”
Wow, BitTorrent as the answer to save indie distrbution !
excerpt “Reduce the cost of revamping healthcare?? Folks, the generally agreed figure is that US healthcare costs per capita are 50% higher than other developed countries. 0.4% is a joke, a diversion. To inflate it, multiplying by ten, makes it a cynical diversion, a PR smokescreen.”
We find a raft of articles suggesting that the effort is stalling amid dissension in Washington and beyond.
Of course. The best way to maintain status quo is a democracy.
An even better way to maintain status quo is to have the government start screwing around with $2.5 trillion dollars. Just sit back and watch the lobbyists and executive vultures from the most profitable and fastest growing industry swarm in on Washington and confuse all those poor congresspeople so that they all get caught up in bickering about details rather than fundamental fatal flaw in how healthcare is provided and paid for in America.
It’s very simple people. In our healthcare system, supply creates demand. When there is a bottomless pot of money to be spent on healthcare, the suppliers will create an endless variety of services and then create demand for those services because they are the ones ordering those services.
Fix that Washington!!!!
If Obama could do anything for healthcare in America, he should relax regulations that prevent healthcare startups from trying to deliver care at half the cost of the big guys. We spend about $7500 per person on healthcare in the US. We know that other countries with much higher functioning systems and higher quality can deliver healthcare at half that cost. The only difference is those other countries have a fixed budget for healthcare, and therefore, rationing. Ours is not a fixed budget. In the US, we spend what we deliver. And we sure can deliver a shitload of bad, profitable healthcare only to receive the trophy for 37th place in the world.
There’s no way around this given the current setup of supply creating demand. A startup will come out of the woodwork and start delivering higher quality healthcare at half the cost. Once employers see that they can get higher quality care for half of what they’re paying today, things will start to change. However, the Feds and States have those startups hands tied by the regulations that prevent this from happening. For example, the Feds dictate how insurance companies pay providers for the delivery of healthcare via Medicare policies. Private insurers simply follow suit and implement many of the same policies. Therefore, a startup cannot innovate how they deliver healthcare for half the cost by taking health insurance money for doing so. They simply wouldn’t get paid for half of their work. Hence, the only way Hello Health can survive and truly innovate is to take cash for everyday healthcare…or encourage people to purchase high deductible plans and pay cash until you spend your entire deductible.
It’s tragic…so many people ask us, “Do you take insurance?” When we say we can’t we’re often written off (however, half of our patients have health insurance). It’s going to take a partnership between innovators and patients to change things from the ground up. Washington won’t do it. The industry isn’t going to sacrifice their revenues. The only way to change things is to partner together…doctors and patients…to build something of higher quality and higher value. We need to disrupt this Sickness Industry and create a health industry designed to take care of your health, not profit off your sickness.
“And the same is true of locating your startup. You can build a great startup in any of the dozen to two dozen startup hotbeds around the world. Pick a place you want to live and work and possibly raise a family. And then get busy.”—Fred Wilson - Startup Hotbed Inferiority Complex (via bijan)
agreed ! that’s part of the reasoning behind my move to Montreal to kickstart keenkong.com
“Newspaper people are living 1950s-style organization-man lives years after that career model became obsolete,”
“The most important words were what came after your name: ‘I’m John Harris of The Washington Post’”—has increasingly become an indication of mediocrity. “In 2006 we didn’t yet know that newspapers were dead,”
There’s an interesting dynamic between the U.S. cellular carriers, Apple, and Palm if you pay attention and read between the lines a bit.
Sprint has been teetering on the brink of death for years. But they managed to get the Palm Pre exclusive, seemingly for at least 8 months.
Palm is effectively betting their company on the Pre. By most accounts, it’s the only current phone that has a good chance of taking marketshare away from the iPhone. Palm needs it to succeed, so they’re challenging Apple on one of the iPhone’s biggest drawbacks and possibly the biggest remaining reason why many people don’t buy it: the mediocre AT&T network that it requires.
In the U.S., that leaves T-Mobile (smaller and slower network than AT&T), Sprint (bleeding customers like crazy), and Verizon Wireless. Verizon would be the obvious choice: usually, people who don’t like AT&T’s network are comparing it to Verizon’s, which has wider and more consistent coverage with much faster and more reliable data service.
Sprint is an improvement over AT&T for data service, but not for overall coverage. While their CDMA towers, like Verizon’s, cover larger areas than AT&T’s GSM towers, they have significantly fewer of them than Verizon.
Clearly, Verizon is the much more desirable network to get the exclusive for both Palm and Verizon. Palm needs to kick Apple’s butt in carrier quality, and Verizon needs a killer device to win back a lot of the customers they lost to AT&T for the iPhone.
Think of how different the Pre’s launch and first year would have been as a Verizon exclusive, especially now that iPhone users are increasingly feeling the limits of the strained AT&T network. It would have been a very strong competitor to the iPhone and the cause of a great deal of worry for Apple. But with Sprint, it’s much more tame, and it’s not really causing a significant disruption.
So why didn’t Verizon get the Pre exclusive?
I can think of two explanations:
Sprint paid Palm a lot of money or made other extremely significant concessions in Palm’s favor. But I don’t think Sprint could pay Palm enough to make up for the value of a Verizon exclusive.
The latter is a much more interesting possibility, and I think it’s more likely. Verizon is notoriously difficult to work with, and has exhibited a consistent delusion in the past that they don’t need specific blockbuster devices and can make their own knockoffs that are just as good. But I don’t think that’s what happened this time. Verizon has lost enough customers specifically to the iPhone that I think they finally noticed at a very high level and are taking steps to fight back.
I think Apple gave Verizon an incentive to turn Palm away.
The public assumption so far is that Apple will never make a CDMA iPhone, waiting instead until the big move to LTE — but that’s still many years away from practicality. I’m betting that Apple will release a CDMA iPhone next year. They’ll face a few inconvenient issues by making a CDMA version in parallel with a GSM version, but the massive Verizon customer base makes the cost well worth it.
Remember the rumors a few months back that Apple had been meeting with Verizon? I think this was why, not the “iPhone mini” that rumor sites assumed.
I think Apple offered Verizon the iPhone — not some other device, and not a cut-down version, but the real iPhone — for 2010, and part of the negotiation was that Verizon wouldn’t take the Pre exclusive. Apple needs to be on Verizon before the Pre gets there, and they’ll do anything to make that happen. Similarly, Verizon needs the iPhone, having potentially lost 5 million subscribers to it so far.
I can’t think of any other explanation that makes sense. And this one makes a lot of sense for every party involved.