Combining social programs and sick care

Paul Levy posts striking data from a report by The Blue Ridge Academic Health Group. A breakdown of healthcare spend (public health, medicine, the two added together) as a proportion of total GDP follows:

Country — % of GDP on Social Programs | % of GDP on Sick Care | Total % GDP

United States — 2.3% | 16% | 18.3%

Canada — 5.8% | 10% | 15.8%

Netherlands — 9.6% | 9% | 19.6%

Sweden — 11.6% | 9% | 20.6%

That’s striking. Though I’m unsure what to make of it. The report says:

Our current health care system is costly and ineffective to an increasing degree each year because it has too limited a focus – sick care delivery – and pays inadequate attention to health promotion. Moreover, the health promotion programs that are in place rarely focus on social determinants of health such as jobs, housing, education, etc. Instead, the focus largely remains on the health problems and concerns of individuals, rather than on the problems endemic to a population.

We know that public health has much to do (most?) with extending life expectancy to its current peak. Medicine, or sick care, has much to do with extending the lives of individuals.

If a fairer distribution of health spend between public health and medicine is the answer then we have a long way to go. The reality, of course, is that public health doesn’t make money. I guess that just needs to be mentioned.

Also worth noting is the report’s mention of a lack of attention to environmental factors contributing to health (of which health services play a relatively minor role) in health promotion programs. Currently jobs are tough to get. Efforts to get anyone and everyone in a house have proved disastrous. Education is great in this country…if you’re in the right community, even that statement is debated.

Rambling is most of what this is. But I think an important consideration to think about is how we, as a country, approach reimbursing for wellness programs. It works. It prevents things. Though it may not save any money on total health care dollars spent, it’s good for people.

The commute is the best part of the day

The conference board says workers’ “commute to work ranks number one as the most satisfying aspect of one’s job.”

Youch.

Links: Design in healthcare

Marketplace story on Sharp Memorial and its use of evidence-based design to build a hospital. Bottom line: better healing.

PSFK presents Ten Radical Rules for Better Healthcare by UK design firm Priestmangoode

Ayyy.

Love cost shifting. As defendable as it might be, it’s just not defendable in reality.

soupsoup:

Shep Smith destroys Sen. Thune’s false claim that Senate health bill will increase premiums: “That’s not true, Senator”

“Five out of every $6 in health care spending today is paid for by someone other than the patient.”
Marketplace

The joy of the chase, the reality of slogging

Love this. First the glorious luster of the idea in finding the next big thing:

Google is famously creative at encouraging these breakthroughs; every year, it holds an internal demo fair called CSI — Crazy Search Ideas — in an attempt to spark offbeat but productive approaches.

And then the reality of improvement sets in:

But for the most part, the improvement process is a relentless slog, grinding through bad results to determine what isn’t working.

Progress, it seems, is so much about the grind. Idea-coming-up-with is glorious and absolutely fun to think about. But the making-things-better part is hard, grind it out work. It’s work.

(Indented remarks from Steven Levy’s look into Google’s algorithm)

Wired, Found: The Future of Medicine

Wired, Found: The Future of Medicine

Lessons From a Blue-Collar Millionaire

Companies that actually (actually!) mean what they say about the culture being most important always seem to be successful. But the thing that’s difficult for me to understand is why so many continue to pay lip service to culture’s importance. Naive on my part? I don’t think so. But I’m biased.

Enter Nick’s Pizza and Pub (they use checklists too!):

Sarillo has built his company’s culture by using a form of management best characterized as “trust and track.” It involves educating employees about what it takes for the company to be successful, then trusting them to act accordingly. The alternative is command and control, wherein success is the boss’s responsibility and employees do what the boss says. Think of the Navy SEALs versus the National Guard. Both approaches can work, but they produce very different cultures. If done right, moreover, trust and track can allow a company to be nimble, flexible, and productive enough to perform at the highest level through good economies and bad.

Trust. Wild concept.