Comments on: Health and the Aspen Institute

By: Wolf19

Wolf19 — Sat, 10 Oct 2009 18:44:19 +0000

Greg Mendel is also, by huge coincidence, the name of the Augustinian monk who is credited with being the father of modern genetics. ,

By: JohnB

JohnB — Thu, 29 Jan 2009 06:49:53 +0000

So why not put disclaimers on soda, like we did with cigarettes?
“The corn syrup in this soda has been shown to cause diabetes from just one can a day”
Anything that makes people think twice is a step in the right direction.

By: Patty S

Patty S — Wed, 15 Oct 2008 01:57:56 +0000

All of this makes the upcoming election that much more interesting and crucial…

By: Charlie Hall

Charlie Hall — Wed, 18 Jun 2008 05:42:30 +0000

Hello, from long ago. I find your comments interesting and informative. It goes without saying, these are not just recent findings. Health care here in the US suffers many maladies including, but limited to: maldistrubution of physicians, a shift in emphasis from Allopathic medicine to other medical/non- medical disciplines, an almost complete disregard for preventative health, and an over -reliance on “hyper-medicine” to save someone in a catarastrophe. And that’s just the beginning. Much more emphasis is placed on after the fact healthcare the prevention, allowing pharmaceuticals to take the place of diet, exercise, and common sense.
US medicine is technically the best in the world, but the delivery falls way short of caring for more than the few with insurance. There is much more to say about this enriched topic, but the space is limited.

By: Chris W.

Chris W. — Mon, 31 Dec 2007 22:53:14 +0000

Also see this insightful discussion on The Health Care Blog, Healthcare and The Long Tail.

By: Chris W.

Chris W. — Mon, 31 Dec 2007 04:04:35 +0000

PS: Also see the rather intense discussion here (NY Times 'Well' blog).

By: Chris W.

Chris W. — Mon, 31 Dec 2007 03:57:53 +0000

On the prevention of infections in critical care (ICUs) there is some good news, and also some rather dispiriting news. See Atul Gawande's recent article in the New Yorker and his op-ed (today) in the New York Times:

A year ago, researchers at Johns Hopkins University published the results of a program that instituted in nearly every intensive care unit in Michigan a simple five-step checklist designed to prevent certain hospital infections. It reminds doctors to make sure, for example, that before putting large intravenous lines into patients, they actually wash their hands and don a sterile gown and gloves. The results were stunning. Within three months, the rate of bloodstream infections from these I.V. lines fell by two-thirds. The average I.C.U. cut its infection rate from 4 percent to zero. Over 18 months, the program saved more than 1,500 lives and nearly $200 million. Yet this past month, the Office for Human Research Protections [HHS] shut the program down. The agency issued notice to the researchers and the Michigan Health and Hospital Association that, by introducing a checklist and tracking the results without written, informed consent from each patient and health-care provider, they had violated scientific ethics regulations. Johns Hopkins had to halt not only the program in Michigan but also its plans to extend it to hospitals in New Jersey and Rhode Island.

By: dlweinreb

dlweinreb — Sat, 15 Dec 2007 22:29:53 +0000

There’s a lot of information about the state of the world’s health care systems in Jonathan Cohn’s review of Michael Moore’s “Sicko”, in The New Republic: http://www.tnr.com/columnists/story.html?id=1fef52d3-407c-4a7f-b835-89601c2e1e8d
He fact-checks the film, and although there is a lot of grandstanding and so on, the substantive points in the film are right. Cohn particularly lauds the French system.

Meanwhile, Henry Aaron points out in the latest The New Republic (http://www.tnr.com/politics/story.html?id=7f7e2f07-86f5-4eb6-86f5-047139f05ef6)
that basically all the Democratic presidential candidates have the same overall outlook on what to do about the health care crisis, while the Republican candidates have pretty much nothing to say about it.

By: rebeccascritchfield

rebeccascritchfield — Mon, 10 Dec 2007 20:05:34 +0000

Adam,

I just arrived home after listening to you speak at the NCI/NIH Consumer Health IT forum in Bethesda.

With respect to your comments about type II diabetes and health care. “If we can just get people to eat a little better and a little less and exercise 30 minutes a day…”

I could not agree with you more. I think the figure is 54 million Americans have pre-diabetes and they don’t know it. They probably won’t find out until they develop the disease even though the test is extremely easy and cheap. (right now blood is needed, but I am sure they are working on ways to measure blood sugar non-invasively)

The question is how do we get people to change behavior and how can technology help? There is no question that the social network and support system is vital. But I think part of the answer lies in knowledge and information access.

My father-in-law is a hard-working farmer who is now retired from the power company. He has always been slender, plenty of exercise on the farm, but he had a huge sweet tooth. He found out he was pre-diabetic when he couldn’t pass his physical. He “looked” like a picture of health, but he obviously wasn’t. His wife is a registered dietitian and she was able to immediately spring into action. They changed their whole home environment. The chocolate cake for breakfast was replaced with oatmeal or cold cereal. No more candy bars at lunch… you get the idea… until they were able to get his blood glucose back down to normal. Now, he enjoys good health and an occasional treat.

But what if he never had the mandatory work physical? Where would he be? How many people are out there who don’t have mandatory work physicals? How many get regular check-ups but don’t ask for a blood glucose test? A cholesterol test? How many people will go on to develop a costly chronic disease?

I was thinking about all this during the panel discussion today. I was thinking about the free market and cell phones and I thought how can we get people better access to personalized health information?

The answer is Brickbreaker (ok, not exactly)… but think about it. How many people have tried Brickbreaker because it was included on their Blackberry? I know my husband loves playing Texas Hold ‘Em on his phone.

How far away are we from a built in application that comes with your smart phone? Maybe it has games to help improve health literacy? Education tools to help improve behaviors like portion sizes, following a balanced diet etc. Maybe it has http://www.mypyramid.gov integrated so you can grocery tips, ideas, menus and a shopping list while you are at the store?

How about a feature that allows you to place your thumb on a smart pad and it measures your blood glucose? Sure, it can ask you a few questions like “do you have diabetes? when was your last meal?” then it takes the measurement and let’s you know if that is normal, high or low.

Could this “intervention” be enough to cause a person to make a doctor’s appointment if the figure is off? I’m not sure. But if they can do Brickbreaker why not try something more?

By: John Moore

John Moore — Mon, 10 Dec 2007 15:29:04 +0000

One of the challenges, which you point out Adam is thee need for the consumer to take greater control of their health and to begin offering incentives encouraging such or dis-incentives for the converse. But event ot get to that point, a massive education program is required. Today, most consuemrs do not take a pro-active role in their healthcare inclduing the management of their own health records. Recent surveys such as the recent WSJ/Harris survey showed that the vast majority of Americans do not manage their own health records, and thus, one could argue do not take a pro-active stance in managing their health. This is where I beleive the physician/providers need to step in and play that critical role of education. They are on the front lines, closely followed by employers who also are a major stakkeholder and are in the best position to offer those incentives for good health practices or dis-incentives for those who employees who chose otherwise.

Also, while you discuss Google (logically) and mention HealthVault, do not forget such efforts as Dossia, which already has a captured audience (via the employees they represent) of over 8.5M. They have the potential to be a major player as well. Recently wrote a past on them which you’ll find at http://www.chilmarkresearch.com

By: mtrappe

mtrappe — Fri, 07 Dec 2007 04:15:28 +0000

Healthcare will benefit greatly from a more proactive approach. Hospitals are making great strides to prevent dangerous and costly infections for patients while reducing costs. MRSA infections are not only deadly but can cost around $30,000 dollars per patient in treatment costs. With an estimated 90,000 patients in the US contracting an MRSA infection this past year, MRSA infections alone cost the healthcare system around $2.7B in treatment costs as well as around 18,000 lives per year. To prevent these infections, Illinois and the VA system have recently mandated that all incoming patients are screened for MRSA before entering the hospital. More preemptive efforts like this are needed in order to save lives and reduce healthcare costs in our country.

By: mtrappe

mtrappe — Fri, 07 Dec 2007 04:13:54 +0000

By: tecosystems » links for 2007-12-02

tecosystems » links for 2007-12-02 — Sun, 02 Dec 2007 05:24:57 +0000

[...] Health and the Aspen Institute « Adam Bosworth’s Weblog fascinating look at the state of health care and potential approaches (tags: healthcare adambosworth) [...]

By: Smokinn

Smokinn — Sat, 01 Dec 2007 03:14:40 +0000

Wow it’s really incredible how staggering the numbers are.

I’m happy I live in Canada. I’d be so exasperated by people just blindly ignoring the oncoming disaster if I lived in the US. I wish you luck, I really hope you succeed in helping the American health system.