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Firehose of healthcare cost resources

By healthcare industry, healthcare price transparency

caduceus dollar sign scaleI attended the 2nd edition of the bill conference in Richmond VA today (for the record, that’s Saturday, April 6, 2013), and wound up kicking off the talks with what’s become my core topic: #howmuchisthat, healthcare edition. That link goes to the hashtag’s home on Symplur, the healthcare hashtag registry that’s also a veritable time-sink of terrific healthcare thought leadership. Including healthcare data visualization. You’re welcome.

Why is this a topic I care so much, and know so much, about? I believe that in all the hot air that’s been expended in the discussion about healthcare and healthcare reform in the US – and boy, howdy, is that some hot air! – very little shrift is given to how consumers (commonly called “patients”) can effect grassroots change themselves. The firehose below takes a wander through the history of US healthcare, particularly from the cost angle, and resources that the average human can use to start figuring out, ahead of time, how to assess the value (medical and fiscal) of their healthcare options.

Here’s the firehose.

Steve Brill’s epic TIME piece, Bitter Pill  pack a lunch, it’s the longest article TIME has ever published

My take on where Brill missed the mark on his “fix this mess” recommendations

A Feb. 12 post that raises Brill’s issue in what I think of as a great-minds-thinking-alike synergy

My health econ guru Uwe Reinhardt’s Chaos Behind a Veil of Secrecy article in January 2006 edition of Health Affairs

A post that includes intel on the RUC and the LA Times piece – both of which I mentioned in my verbal firehose

A NY Times story on the unintentionally hilarious 2013 report in JAMA (Journal of the American Medical Assn.) on the wide disparity in pricing for hip replacements in the US – the RUC is an AMA committee!

Society for Participatory Medicine $30/year, very passionate and engaged membership which is driving real change

ClearHealthCosts.com, NY startup that’s crowdsourcing healthcare costs

Costs of Care, a 501(c)3 dedicated to helping patients drive down healthcare costs

Leapfrog Group’s Hospital Safety Score database

AHRQ (Agency for Health Research and Quality), part of the US Dept. of Health & Human Services

My 1st Disruptive Women in Health Care post, wherein I make some recommendations about break/fixing the health insurance model in the US (and yes, its headline is totally a shout-out to Jonathan Swift)

A year-later post from the Mighty Mouth blog with some additional suggestions on that break/fix, and why not doing it could be the hidden killer of the US job market

Oh, Jerusalem!

By Uncategorized

My life at times feels like one long experiment in whatever the reverse of “aversion therapy” is in regard to bugs. Particularly spiders. I can tolerate spiders up to 3/4″ in span, but once they get bigger than that I start to hyperventilate. Which makes orb weaver season here in Virginia a challenge. One of the little dears will invariably, overnight, make a web across the back door. When I open the back door, I’ll almost get spider-face.

My favorite, if one can call it that, bug story started when I was eleven, and had its big finish when I was twenty. At eleven, I was living in Coronado CA, in a house that’s still my favorite-I-ever-lived-in. A stucco and tile hacienda-style deal, with a central courtyard that had an olive tree and an entire wall of morning glory vines.

One night, I was in my bed reading, when I caught movement out of the corner of my eye. On the other of the twin beds, a bug built like a combination between ant and grasshopper – three-segmented body, long articulated back legs – and the size of a woman’s size five shoe was making its way along the side of the spread.

Like the good eleven year old Girl Scout I was, I screamed my head off and bulleted out the door to the courtyard. My parents didn’t see the bug and chalked up my screaming fit to imagination.

I slept on the couch in the living room for two weeks.

Nine years later, I was living on Mt. Davidson in San Francisco, in a basement apartment with two other girls. I awoke one night to banshee screaming – my roommate was dancing around her room, waving her (extremely long) hair around like one possessed. Once she was coherent, which took a while, she stuttered out that “it..it..was on my foot, and..and..then it ran up to my neck and it was in my hair!” “It”  was an insect.

I didn’t see “it”.

A week later, I was standing in the door to the screaming, long-haired roommate’s room. She was sitting on her bed. She stopped talking and her eyes bugged out looking at something near my feet. I looked down. It was the bug from my room in Coronado. Or at least its cousin. In a fit of sangfroid, I grabbed a  large plastic bowl that just happened to be handy and put it down over Bugzilla.

About twenty minutes later, a male friend arrived for beer and skittles (or at least tacos) – we three maidens did the “oh, we need a big strong man to kill the bug” dance. He puffed up his chest, smirked a bit at our girlish fright, grabbed an old magazine, and proceeded to the bowl.

He up-ended it, screamed like a Girl (Scout), and then the sound of furious smacking ensued. For at least three minutes.

When he finally reduced the magazine to pulpy shreds, he was pale and sweaty. His only comment was “f*ck, that thing was HUGE!”

I later found out said bug is called a Jerusalem cricket, or a potato bug. Here’s a picture. I still have trouble looking at it…

jerusalem cricket

My ISP Is a Bad Boyfriend

By Uncategorized

They don’t call.

square blog with bad boyfriend in white text

credit: bad boyfriend society

They make promises they know they’ll never keep.

They stand you up, repeatedly.

Bad boyfriend! Bad!

But they’re charming, and their promise-making is so very seductive that you forget, in the moment, that what they’re telling you is lies, damn lies.

But they lie so very well.

I came to the heartbreaking realization recently that I had another bad boyfriend…and this time it was my internet service provider. Darlin’, no one can break your heart like an ISP.

When I moved in January of 2006, I decided to switch from DSL to cable broadband. My DSL relationship had been fraught with dissention and argument, very reminiscent of Controlling Lover From Hell syndrome.

This CLFH was fond of trying to make me think I was stupid and unworthy by imperiously suggesting the technological version of self-improvement was what I needed, not a switch from copper to fiber.  This CLFH was also on the Indian subcontinent and in possession of marginal English skills.  I’ve never enjoyed transcontinental, semi-bi-lingual relationships, so I knew a breakup was inevitable.

When the time came, I fell for a seductive voiceover purring the “I’m so much faster” line.

I failed to remember that when it comes to seduction, who wants fast?

I was moist with anticipation when our consummating date – the install – arrived. The sinuous cables snaking their way into my home office promised a fast and hot experience.

What occurred was “failure to launch” – in this case, failure to deliver a connection.

Six months of emotional drama ensued – pleading, threats, promises, broken appointments, flowers (in the form of bill credits) – with no resolution, and only occasional bliss in the form of actually connecting.

Mostly, it was just like dating someone whose IQ is half yours but who looks good – you know you’re kidding yourself, and sooner or later it will all end in tears.

Bad boyfriend! Bad!

The strangest thing happened after I met someone else, though. I was flirting, and had started to talk about making a date with this fascinating new fiber god when suddenly – surprise, surprise – the bad boyfriend suggested relationship counseling.

The counselor (in the guise of the VP of Operations) scheduled group therapy, and actually made a house call.

I had been begging, pleading, even weeping for new cable from the pole to my house for six months. “No, no, honey,” I was told repeatedly, “you don’t need that.  You need a new modem/network card/Cat 5 cable/router/computer.”

In other words, “It’s not me, it’s you!”

Bad boyfriend! Bad!

On that hopeful and shimmering day when couples therapy made a house call, the counselor listened.

He evaluated.

He spoke.

He said, “You need new cable from the pole to your house.”

And he made it happen.

Since then, we’ve had the hot, fast computer-on-Internet action that dreams are made of – and that the rotter promised me at the beginning.

But I’m not lulled into complacency, or stupefied by satisfaction of desire. There’s a new fiber god coming to the neighborhood. To keep me around, my bad boyfriend had better keep me in the style to which I’d like to become accustomed – by lowering his rates – or this girl’s movin’ on.