Population Health and Patient Engagement
Could a Population Health System Improve Patient Engagement?
That was the question asked in an article by mHealthIntelligence.com, but after asking the question they gave no place to reply, so today’s post is my response, which is also posted on LinkedIn.
America arguably has the best Medical care in the world, but we really don’t have a HEALTH care system.
According to the WHO, Americans live sicker and die younger while spending twice as much as other nations on medical care. So imagine the benefits of prioritizing Population Health, along with the public policies that could/should result.
Besides just understanding what contributes to poor health (poverty, obesity, stress, sedentary lifestyles, our food supply, a toxic environment, etc.), and crafting policies to address those contributors, we would also seek to understand what contributes to good health (nutrition, exercise, sleep) and find ways to improve those, including putting in place incentives that cause behavioral change. It makes sense, because as Benjamin Franklin said, “An ounce of prevention is worth a pound of cure.”
What would be the impact of this change in thinking? First is the real potential of cutting medical spending in half while improving outcomes, thus saving about $1.5 trillion/year. And with better health would come better productivity, in school and business, leading to improved GDP and competitive positioning in world markets. That could theoretically be worth another $1 trillion/year.
What we might do with those savings would depend on our priorities and how we see ourselves as a society. We could use it to pay down the national debt, and fairly rapidly; or we could use it to invest in education, infrastructure, research and things that contribute to further wealth; or we could build up our military and fund more wars.
Tax Reform for Health Reform
I’m talking about investments, and since you have to spend money to make money, where does the required initial funding come from for those investments? If we want universal healthcare that focuses on health, how do we get there and pay for it, even if we know the result has savings? Since we don’t want more borrowing, it requires a major change to our tax code, but since the poor and middle class can’t absorb that and already spend nearly all they make just to live, the only sensible answer is to tax the Uber-wealthy who already have trouble spending all that they make. So, putting more money in the pockets of the poor and middle-income leads to more spending. They’re the biggest contributors to the economy by far, and their demand for products is the real job-creator.
We don’t have to return to the Eisenhower days when there were many more tax brackets and the top rate was over 90%, but we should understand that that helped fund economic recovery after WW-II, helped us build the interstate highway system, and enabled decades of prosperity to make America the economic power it is today. We got there because we invested, and we taxed so we could invest. Those who were taxed the most ended up benefiting the most, but we all benefitted.
Then came Regan, with lower taxes, fewer tax brackets, and the beginning of definite spending. Then came the Citizens United ruling to further the corrupting influence of big money in politics. And then came the consolidation of news media and the 24/7 news cycle to convert news reporting into commentary & opinion, with people attracted to one news source or another, and one ideology or another, thus polarizing our political system.
Could a Population Health System Improve Patient Engagement? I think Americans are ready to get engaged. They’re mad as Hell at politicians, and at a medical care system that views patients a paying customers and treats symptoms to keep them coming back, paying. If you agree, or disagree, add your comment below, and share this post with friends.
