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November 29, 2011

Let's Talk Health Care

Harvard Pilgrim Health Care is re-launching Let's Talk Health Care, which started life as former CEO Charlie Baker's blog. There's a series of related discussions going on now in the Let's Talk Health Care Linked In group, sponsored by Harvard Pilgrim.  I've been participating (at the request of the group organizer; disclosure: client) and would like to invite you to do the same.

A salient characteristic of the site and of the group is the focus on three broad categories of care and cost: fostering health and wellness, balancing quality and cost, and redefining care coordination -- all of which are informed by a focus on chronic health care issues.

One of the great successes of modern medicine is the conquest of most infectious disease.  (Equitable global distribution of the tools necessary for eradication is another story -- and some of the more compelling chapters of that story are being told these days by The Bill and Melinda Gates Foundation.) One of the great failures of the modern consumer state is the development of the contemporary couch potato, inactive and over-laden with processed foods, e.g., government-subsidized high fructose corn syrup.  Let's Talk Health Care, like most contemporary health-focused web properties and their sponsors, is laser-focused on wellness (well, OK, everyone has an agenda, and Harvard Pilgrim is an insurance company, so the focus spreads from wellness to encompass a broader focus on affordability of care as well). Targeting prevention and management of chronic diseases that sap health from people, productivity from their employers, and cold, hard cash from all of us is critical; employees, employers, and buyers of goods and services are all called upon to pay the piper, so we have a community of interest here.

As an example of the conversations going on in the group, take a current thread that I kicked off, regarding employers partnering with employees around health care and wellness.  I invite you to join in and offer your perspectives -- what works, what doesn't work, what would you do if you were king or queen of the world, etc.  In my humble opinion, a ton of resources are spent on wellness programs in an unscientific manner -- meaning they are not necessarily spent addressing issues that are, or should be, of great concern to the employee population targeted, and they are not necessarily spent on interventions that work, or that work on a long-term basis. For example, the health reform law is throwing additional money in this direction: $200 million in grants will be available to small employers kicking off wellness programs since the law was passed, and the law also provides the opportunity for employers to subsidize health insurance premiums in exchange for wellness program participation (the maximum premium discount has been raised from 20% to 30%).  Unfortunately, observations of some participants in this on-line conversation support my understanding of the situation here -- incentives to participate in wellness programs in the form of cash (or insurance premium discounts) do not seem to motivate folks sufficiently.  

Collectively, we need to get a bigger bang for the buck in this arena -- and to do that, we need to spend our money more wisely.  Some people are focused on figuring out just how to do that, including, for example, BJ Fogg ("Persuasive Technology"), who I was glad to see present at a conference here in Boston a year or so ago, and entrepreneurs behind such online offerings as HealthMonth and StickK (as well as numerous folks behind stealth and beta sites in this space, some of whom I'm working with now) -- which seek to encourage healthy behavior modification in part by keying into the social levers that affect human behavior.

The goal here is to get the conversation going, and to surface ideas that can benefit all of us --employers, employees, payors and providers.  

The days of couch potatoes saying "I'll take a pill for that" are over.

David Harlow
The Harlow Group LLC
Health Care Law and Consulting

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