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Tuesday, February 25, 2014

#HIMSS14 Day Two

Nothing like a good night's sleep, after getting in late Sunday night from SFO after a long day in the air on JetBlue, SFO -- JFK -- MCO. I was pretty much on fumes yesterday.


Click here for the full infographic. Very nicely done.

Years life expectancy taken to 2 decimal places -- or, 3.6525 days. So, notice that our ~9x per capita spending vs Bahrain "gets us" 0.19 of a year relative longevity. Not quite two months. And, yes, it's utterly explainable by factors having nothing to do with spending.

The big news -- actually, not news -- is the money, as Aetna CEO Bertolini noted so vividly in his opening Keynote. Unsustainable. We all know that. We also all know by now the inordinately high relative cost of those heavy upper tail Frequent Fliers and their intractable comorbid chronic dx's. Turning that around will be no small or quick effort. A problem in the U.S. ADHD Policy World that runs at best on 2-3 year cycles. We tend to flit from one initiative to another, petulantly impatient with equivocal early findings, ready to summarily call something (e.g., like MU or ACOs) "a disaster" in order to roil up the rubes.

See my 2013 takedown of the dopey "REBOOT Report."

More on the "money" thing. Say by some miracle (just for grins) we're able to cut per capita health care cost in half. $8,233 / 2 = $4,116.50. Family of four? $16,466 a year, $1,372 per month. Further assume President Obama's "$10.10." $10.10 x 2,000 hours in a full time work year: $20,020 were that the minimum wage. Further assume two working parents at minimum wage: $40,040 a year combined gross income (absent subsidies, of course).

~41% of gross income devoted to health care. Gross. Do some back-of-the-bar-napkin estimates on "net," the income number that matters.

Simplistic, just to make the point that it's not gonna be -- cannot be -- cheap by any measure. In any given year, to be sure, our individual heath care expenditure will range from to zero to 6 or 7 figures. The entire priority point of the PPACA is to get more people into the (mostly pre-payment) pool long-term. Eliminate the fiscally enerverating "Free Riders" (regarding which I wrote and recorded a song, btw).

Everyone, have a great day today at #HIMSS14!

The next great public health issue?


More to come...

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