Archive for health care
Well, it turns out he did.
What did he say? Hang on. I’ll get there in a sec.
First, I’ve been silent here for a while (holy crap, I haven’t posted since Jan. 31!) – my only excuse is that I’ve started blogging for clients, and ran out of words. Not really, but that’s my story, and I’m stickin’ to it.
Back to our programming already in progress: Did Warren Buffett really say THAT?
WHAT DID HE SAY?
Well, he said this (on CNBC in July last year), kids:
“I could end the deficit in 5 minutes. You just pass a law that says that anytime there is a deficit of more than 3% of GDP, all sitting members of Congress are ineligible for re-election.”

No Labels. Not left. Not right. FORWARD.
Boo-yah! This is essentially what my buddies at No Labels have been saying since they released their 12-point plan to make Congress work back in December. #1-with-a-bullet of those 12 points is No Budget, No Pay. Which, by the way, had a subcommittee hearing earlier this month. Progress. It’s a game of inches, but we’re racking up those inches.
Speaking of fighting for inches, the healthcare reform act – or Obamacare, whatever your radio tells you that you should call the Patient Protection and Affordable Care Act – is in oral-arguments phase in front of the Supremes this week. I’m on record as thinking that this iteration of healthcare reform isn’t anything but an attempt at healthcare *payment* reform, but that’s not why I brought this up.
If you care about controlling healthcare costs – your own or anyone else’s – you must read e-Patient Dave deBronkart’s latest epic opus on what happens when a healthcare consumer tries to find out what something costs. The insurers don’t know, the hospitals sure as **** don’t know, so what’s a patient to do? Keep asking. Keep demanding answers. Keep it up until we all get healthcare to post its rates clearly, and in public.
I promise not to go quiet again. You can guarantee that by leaving a comment, or sharing this post.
Ready, set … GO!
In its rigorous search for food & drug safety, the FDA added searching through the personal emails of agency employees who questioned FDA decisions.
That would be an oops – for both sides of that story.

(c) PBS | Frontline
Here’s the lowdown: on Sunday (Jan. 29, 2012) the Washington Post reported that the FDA was being sued by staffers – scientists and doctors charged with testing medical devices – for harassment and wrongful dismissal as a result of the agency’s surveillance of their personal email accounts. That email surveillance revealed that the FDA staffers were contacting Congressional staff with whistle-blower complaints about FDA approval of devices that the scientists and docs thought were a risk to patients.
Hue and cry! Bad FDA!
Actually, I agree that the snoopy surveilling of personal email accounts is creepy, even wrong.
However, here’s the rub: the FDA staffers were accessing their personal email using computers at work. At the FDA. Within the Federal government IT infrastructure. You know, the people that oversee other stuff like Echelon. And the Pentagon. Gee, FDA guys plotting whistle-blower campaigns on work computers – stupid much?
On the FDA side of the story, we have creepy fascist tactics deployed by an agency that should be all about making sure that no pharmaceutical, no medical device, no food product makes anyone sick. Or worse, dead.
The record there? Not so stellar. Can you say Vioxx?
On the outraged-former-employee side of the story, we have some folks who thought they were veryvery smart (scientists and MDs always think that, trust me), but who played veryvery stupid on the interwebz.
Accessing personal email on a computer that belongs to your employer is pretty dumb if you’re doing or saying anything that casts a shadow on the hand that feeds you. Yes, that means you become the bad dog, and that’s not a great role to play. Because “no-no-bad-dog!” translates to “your ass is fired” in this scenario.
Even if you’re on your own computer, and you’re using your employer’s network or VPN, you have no reasonable expectation of privacy.
It boils down to this: just like anything else on the web, don’t put anything on it/through it unless you’re willing to either have it on page 1, above the fold, of the WaPo or the New York Times. Or your boss’s desktop.
The saddest part of this story is that the FDA really does need a total tear-down. It’s become too obstructionist to what could really improve public health, and too easy-peasy for big-money players who want to make the system work for Citizen Corporate, not Mr./Ms. Every-patient.
This lawsuit could become quite the precedent-setter, if it gets past the lower courts with its plaintiffs intact.
Stay tuned for further developments. I sure will.
That’s my story, and I’m stickin’ to it …
I’ve asked this question frequently over the years, starting in the ’80s, continuing to today … and I’ll keep it up until someone realizes that it’s a failed paradigm.
What we have here, kidz, is what happens when a society decides that socialism is anathema, but doesn’t empower and educate its citizens about how to take responsibility for themselves in ways that will keep them healthy, productive community members.
Business started picking up the tab for healthcare during World War II, when stiff wage controls made it impossible for defense plants to give their employees raises. In place of more money, they started to pay for health insurance – which state and federal government were more than happy to turn into mandated employee benefits over the next 20 years.
What happened then was predictable: three generations have been out of touch with the true cost of healthcare, and the true cost of their choices about their health. If you’re a good little American consumer, you do whatever your television tells you to do: eat this. Buy that. Otherwise the terrorists win!
Three generations of disconnection from the real costs of our medical care have delivered us an epidemic of obesity – thanks to plentiful empty calories, courtesy of agri-business, and our willingness to beach ourselves on our sofas, in our SUVs, or at our computers, the better to receive more messages about what we should buy and eat.
Health insurance costs have skyrocketed as we’ve become a nation of couch potatoes. Companies are scaling back their employee health benefits as those costs continue to rise, putting more and more people in the un-insured or under-insured bucket.
Here’s a suggestion: sell health insurance like auto, home, and life insurance are sold. Put consumers in charge of shopping for, and purchasing, their own insurance. Let business help their employees, if they choose to do so, as a true benefit rather than a mandate. Help every consumer set up a Health Savings Account for their healthcare expenses. And stop the state-by-state divvy-up that lets health insurers essentially gerrymander the health insurance marketplace.
Put consumers fully in charge of their insurance, and their care. Turn the health insurance market into a car-insurance model. People can buy minimum levels of insurance, and assume the risk of that choice. They can opt out completely, and assume all the risk for their healthcare costs. Make it a true marketplace, rather than the giant mess that we currently call health insurance.
Radical? Perhaps. Necessary? I’d say it’s essential.
Until we’re put in touch with the costs of our healthcare, we won’t be encouraged/empowered to take control of our health. As long as we’re using other people’s money to pay for healthcare, we’re stuck where we are.
Which is a very bad place to be.
That’s my story, and I’m stickin’ to it …
Healthcare providers are waking up and realizing that they need to partner with their patients to get better outcomes for their facilities and practices, and for their patients. As Accountable Care Organizations (ACOs) get more and more press, the healthcare delivery side is the entity being held accountable.
Patients must step up to the bumper on accountability, too.
Two phrases have entered the medical lexicon thanks to the Patient Protection and Affordable Care Act, a/k/a “healthcare reform.” PPACA is not actually healthcare reform, it’s health payment reform, but I digress. The two phrases are “patient-engagement,” and “patient-centeredness.” Doctors are being told that they must engage with patients, and offer care centered on their patients’ needs … but that engagement and centeredness message is not being simultaneously driven toward patients.
Therein lies an opportunity for #fail.
Patients need to take responsibility for their health, their actions, and their care. I’m not saying that we should shut up, sit down, and do what we’re told. What we must do is ask questions, work to understand the answers, and then do what is in our own best interest, health-wise.
That does not include ignoring instructions to cut down on salt or saturated fats. It most certainly does not involve living on drive-thru meals and expecting a prescription to resolve your expanding waistline or blood sugar numbers.
In this month’s HealthLeaders, Joe Cantlupe talks about how doctors are making more robust suggestions to their patients, with the goal of turning medical care into a true partnership between patients and providers.
Healthcare providers need to step up and work with their patients, turning healthcare into a team sport.
Patients MUST step up and take responsibility for their choices as well as a full share of decision-making.
That’s my story, and I’m stickin’ to it …
I had the opportunity to speak at a digital pharma marketing conference – DTC Perspectives’ Marketing to the Digital Consumer – last week. “DTC” is Direct To Consumer, by the way. I was representing the patient voice, at the invitation of my friends at the health activist community WEGO Health.
It was terrific for several reasons – connecting with other healthcare social media peeps in pharma, meeting and mingling with some powerful voices in pharma leadership, learning more about the regulatory environment that pharma marketers work in – but the biggest “wow!” that day happened between my ears.
I realized that pharma – and healthcare in toto – is desperate for its own #arabspring. A complete re-alignment of the entire system, driven from the bottom up, that will benefit all players: pharma, health systems, clinicians, researchers, patients … people. All of us.
This epiphany arrived courtesy of a combination of factors.
First, I felt a little like a zoo animal, since I was the only one at the conference wearing an Official Patient sign. I found that amusing, since everyone in the room is a patient at some level, even if they’re only seeing a doc once a year for a check-up. I’m not even a pharma consumer who’s on a buffet of drugs, although I do take a fat handful of supplements every morning. Why are patients seen as exotic creatures by pharma, and by most of the healthcare industry?
Patients = people, people. Treat us like … people.
Second, since I also wear a PR/media/content-creator hat, I saw that they were making a real effort to understand how they could take advantage of social media as a direct-marketing tool. They were approaching this as an industry with a huge regulatory oversight burden, from the FDA to the US Patent & Trade Commission to the host of regulatory bodies in other countries where these companies sell pharma products to doctors or direct to consumers.
Some of the regulatory step-on they’re struggling with they brought on themselves with “me-too” drug formulation and disease-mongering (“restless leg syndrome”? Really?). In conversation with a couple of high-level folks from big pharma, I learned that they routinely hear “we’ll have to run this past sales” when they want to try a new approach to communicating with their market. Why does sales drive communication? If pharma wonders why they’re seen as a scrum of hucksters, look no further than “running it past sales” when it comes to new ideas.
That combination of being seen as an exotic because I was a patient, and recognizing that, as an industry, pharma is an inverted pyramid crushing itself under the weight of heavy regulation caused, and continued, by a run-it-by-sales communication model, led me to the idea that people (a/k/a “patients”) need to #arabspring this b*tch.
People – patients – need to examine their relationship(s) with healthcare, and pharma, and ask what value they are getting from those relationships. Tell those that help how they’re doing, and tell those that aren’t to either clean up their act or take a hike.
Don’t fall for disease-mongering.
Don’t settle for less-than-full disclosure from any of your healthcare providers – in other words, ask why your doctor is prescribing a name drug, if a generic is available.
Act as if your health is YOUR responsibility. Get off the couch, call a halt to drive-through nutrition, examine your habits and ditch what doesn’t serve you, and your health.
Engage with pharma companies who provide you or your family with drugs that work, and tell them so.
Rabble-rouse the FDA to stop standing on innovation, and to start freeing up both farm AND pharm to help us eat better, and help researchers bring new drugs that actually help to market.
Take to the the streets by visiting your local farmer’s market and buying/cooking local. Boycott processed cr*p disguised as food.
The presentation deck I used at the conference, with added narration, is linked here.
I welcome comments, arguments, suggestions.
I recommend that you read my buddy Phil Baumann’s take on “we are all patients”. (He’s right, BTW – which is why I say patients = PEOPLE, people.)
That’s my story, and I’m stickin’ to it …
I had the opportunity/privilege to participate in a conversation with other health activists and e-patients about a Digital Patient Bill of Rights recently.
I’ve posted an overview of the conversation on the Cancer for Christmas blog. Give it a read, and tell me what you think. Really.