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April 29, 2019 By e-Patient Dave 3 Comments

Getting ornery on social media: What I’m doing in 2019, episode 2

Sunday night I blogged this:

I haven’t been blogging nearly as much as I did five years ago, largely because my early blogging was all about trying to figure out “what the heck is up with the American healthcare system???” … it’s been two years since I had any new realizations.

Why would “figuring it out” make me stop blogging? Because as a change activist who’s also a public speaker, I’m gripped by one question: “What could be said that would make any difference?” There literally is no point in saying anything else. So once I realized how locked-in the system is, how intractable it is to change, I lost interest in flapping my gums and fingers.

But new things are in the wind, and it’s time to start pushing out those top learnings as foundation for what’s next. So, game on – in responses to two tweets, I got ornery:

[Read more…]

Filed Under: consumerism, cost cutting edition, Culture change, Evolution, Health policy, Patients as Consumers, Social media 3 Comments

April 28, 2019 By e-Patient Dave 8 Comments

What’s up with the US health system?? (What I’m doing in 2019, episode 1)

Click to enlarge this composite of images from previous posts

I haven’t been blogging nearly as much as I did five years ago, largely because my early blogging was all about trying to figure out “what the heck is up with the American healthcare system???” and it’s now been two years since I had any new realizations. Here’s a summary of that, then some quick hits on recent and upcoming events.

No, wait – this part turned out long, so I’ll continue tomorrow with the “quick hits.” For today, here’s the baseline I reached two years ago.

[Read more…]

Filed Under: cost cutting edition, Evolution, Health policy, Patients as Consumers, The Big Ugly Tagged With: american healthcare, health costs, patient empowerment 8 Comments

July 13, 2018 By e-Patient Dave Leave a Comment

“What will this cost?” Episode 4 of Power of the Patient, with Clear Health Costs

Episode 4 of the Power of the Patient podcast is live here.

Want better control over your health costs? Investigative journalism has finally come to healthcare, and it’s winning prizes bigtime.

My guest Jeanne Pinder is a former New York Times editor whose company Clear Health Costs has just won the Edward R. Murrow award for investigative journalism, for their contribution to the “Cracking the Code” series in New Orleans. [Read more…]

Filed Under: cost cutting edition, Patients as Consumers, podcast Leave a Comment

November 14, 2017 By e-Patient Dave 6 Comments

American healthcare: a malignant tumor that can’t stop killing its host

As I said recently, I’ve been writing less here for a number of reasons. One is that I’ve been asked to write on other sites. Another, a sobering factor, as that after years of study, I’ve concluded that the American healthcare system has tied itself in a fatal knot. The post shown here, on the Patient Power blog, is an example of both.

[Read more…]

Filed Under: cost cutting edition, Health policy, Patients as Consumers 6 Comments

August 16, 2017 By e-Patient Dave 5 Comments

Rice bytes: best way I’ve seen to understand giga, mega, peta and such

I love anything that makes it easier for people to know what’s going on. Case in point: this tweet yesterday from Twitter friend David Grayson @Sasanof, from the IBM Watson Summit in New Zealand.

You can use this to understand enormous sums of money, too:

$1 = one grain of rice
$1000 = cup of rice
$1 million = 8 bags of rice
$1 billion = 3 trailer trucks of rice
$1 trillion = 2 ocean freighters (3,000 truckloads)
$3 trillion (the US healthcare budget) = 6 ships (9,000 truckloads)

When someone says a health improvement project will save (or cost us) $100 million a year, it’s a lot, but think:

  • The proposed amount is like 800 bags of rice.
  • The US health budget is 9,000 truckloads of rice

Puts it in perspective.

Thanks to @Green_Goddess, Caroline Taylor, CMO of IBM Global Markets, for the visualization, and to @Sasanof for tweeting it. Don’t I love how social media helps ideas spread??

Update next day:

One of my very early blog posts, on my old blog, was on this same subject. March 9, 2009: Comprehending the US healthcare budget. Here are the graphics from that one:


Here’s a million bucks’ worth of $100 bills. (That’s 100 packets of 100 $100 bills; each packet is 1/2″ thick.)


Here’s 100 times as much – a million hundred-dollar bills, $100 million:


Ten of those – a billion:


And a thousand of those – a trillion. Check out the little dude, who’s now in the bottom left corner:


And US healthcare is three times that size.

This helps me, for one, start to comprehend the magnitude of the problem. Something like that does not shrink willingly: lots of people would lose their jobs, including CEOs etc.  That’s why I liken US healthcare to “a tumor that doesn’t know how to stop growing and killing its host.”

Go back up and take a look at the size of one million in this picture. Urk.

Filed Under: cost cutting edition, Social media 5 Comments

June 16, 2017 By e-Patient Dave 3 Comments

The effectiveness of the US health system, in one graph

I’ll leave you with this thought for the weekend.

After years of study of healthcare around the world, listening to an immense number of arguments about what’s important and what works and doesn’t, it’s all summed up in this one picture. The Y axis is life expectancy; the X axis is cost. This graph has been tweeted furiously and often lately by health journalist @DanMunro. (More on him below.)

You can easily see that US health costs per capita are way, way, way out of whack with the rest of the world. And, the life expectancy we get for it is years worse than the countries that cost 2-3x less.

Some will argue bitterly that the facts aren’t relevant, or a hundred other arguments.  I’ve lost interest in those arguments, because they’re all about rationale, and no rationale is worth a damn if the outcomes they’re trying to explain don’t match the rationale.

[Read more…]

Filed Under: cost cutting edition, Patients as Consumers, The Big Ugly 3 Comments

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