Search the KHIT Blog

Monday, January 16, 2017

Health 2.0 #WinterTech 2017

Following up on my prior post. Above, Julia Morgan Ballroom, 465 California Street, downtown San Francisco, 7 a.m., the calm before the storm.

Above, the emblematic WinterTech 2017 slide of the day. The recurrent major topic was that of speculations as to the future of "Obama Care" (and specifically what it portends for #SiliconValley and venture capital investments in Health IT) under the incoming Trump administration. Below, the signature of Tea Party Republican Dr. Tom Price (orthopedic surgeon) of Georgia, Trump's nominee for the next Secretary of HHS." The Price is Right?"

Above, an audience phone-text poll on the likely alternative futures of Obama Care under Trump. "Obama Care Lite with Slowed Value" was the winner with about 2/3rds of the vote. ("Obama Care Lite" meaning that "repeal" measures will be in large measure "cosmetic" --  meant to be political pacifiers, while core coverage elements of the ACA will remain quietly in place, with some decrements in "value" QI initiatives).

Anybody's guess at this point. As I write, it's Monday Jan. 16th. This headline blares forth online at HuffPo:

President-elect Donald Trump says he’s putting the finishing touches on his plan to replace Obamacare.

It sounds absolutely terrific, like the best health plan ever!

It also sounds wildly out of step with what Republicans in Congress, or even some of Trump’s own advisers, have said they would like to do.

Trump’s comments, which he made in an interview with The Washington Post that appeared Sunday, could mean he’s gone rogue and decided that, at least on health care policy, he has more in common with Sen. Bernie Sanders (I-Vt.) than House Speaker Paul Ryan (R-Wis.).

Or they could mean that, in reaction to public anxiety and recent protests over the possibility of more than 20 million people losing insurance, Trump is already misleading people about what he and his Republicans are planning to do.

Or Trump’s statements could mean that he has no idea what he’s talking about...
You're gonna get cognitive whiplash trying to stay abreast of this stuff.

Succinct summary update of the day's highlights in my inbox:

Co-host Indu laid out the day's WinterTech themes at the outset, based on emergent trends stemming from 2016:
  • New care delivery models;
  • New insurance models;
  • Technology advances;
  • Analytics;
  • Emerging (non-U.S.) markets.
If there was any consensus coming off the stage as to where things are headed, it was a prediction of inexorably increasing patient "OoP" (Out of Pocket) participation in health care expenditures, and whatever that may imply for "innovative care delivery" and other "consumer-facing apps" models.

BTW: The policy debate has been fairly raging over at THCB these days. I mostly stay out of the comments of late. Let these (mostly untraceable screen name) know-it-alls have their respective contending says.

To me, health care policy arguments ignore a couple of fundamental things. First, there's the "Ich/Du/Sie" PoV problem:
  • I deserve full, affordable first-dollar indemnity coverage for my medical misfortunes;
  • You need to have significant "skin the the game" to inhibit you from overutilization, which drives up my costs;
  • He is a mooching parasite, a free-rider driving up my costs.
Then there's the ideologically glossed-over actuarial reality:
Health care UTIL risk is roughly, speaking of only adults in E-Z round numbers, a 60-year proposition tightly coupled in the aggregate with age (in sort of "hockey stick" fashion). We have long known this. Yet we continue to insist on selling "coverage" (much of which is 3rd party-intermediated "pre-payment," not "insurance") in one-year chunks (wherein everyone thinks they're getting screwed on both the insuree and insuror sides). None of the ensuing administrative paper-shuffling going to deductibles, co-pays, coinsurance, and other fine-print policy babble adds any value to actual care delivery (notwithstanding its profitability to the intermediaries).
Of course, the alternative would be the "social insurance" model now decidely out of favor with the GOP.

Some random photos from WinterTech...

All told, an interesting day, notwithstanding the intractable equivocality of the myriad learned opinions set forth.

Met some cool people.
  • Aristotle Mannon, Founder and CEO of bosWell. "Client data collection, made simple.
    bosWell provides free web-based record keeping and reporting tools for community based organizations."
  • Ursula Hessenflow, CEO and Co-Founder, myLAB Box. "myLAB Box is a first-of-its-kind service that delivers STD screening solutions to your doorstep allowing you to keep private things private."
I spoke with a young woman with the company DesignMap, one of the WinterTech booth vendors.
"User experience design to improve the workplace."
"DesignMap brings years of experience from internal teams, startups and enterprise tech firms to deliver smart 
solutions to make enterprise software great."
I asked her a number of questions going to EHR "usability" (UX). I don't think she understood the drift. I got nothing but generalities. I expect to have better luck when I do a follow-up with ElationHealth.

 BTW, in the context of "Venture Capital," it's worth revisiting my recent citing of Steve Tobak's fine book. I still think Steve would be a great WinterTech panelist.


My latest book.

From the Conclusion:
Public ignorance means power for institutions, because it lowers the probability of accountability. Institutions are built on delegation of decision-making, which allows a division of labor and the development of expertise. Yet delegating choice also creates the opportunity for abuse, for an agent to take hidden actions against the principles interest or to use limited knowledge about options to pursue an agenda the principal would not favor if fully informed. Information costs involving uncertainty about quality or trust often drive choices away from markets and into the hierarchical structure of firms. Information costs contribute to him perfectly functioning markets when there are negative spillovers like pollution, anti-competitive acts and cartels, or asymmetries in knowledge about goods and services such as with credit, insurance, and healthcare industries...
 Theranos, anyone? apropos, see my recent post "2017: Disruption ahead on all fronts, for good and ill."

More to come...

No comments:

Post a Comment