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Health care as you transition to civilian life: Pt. 2
Transcript Welcome back to our series on your health care as you transition to civilian life. Last time, we discussed the Transition Assistance Management Program, which expires after 180...
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Part IV: The House - Virtual Tour of the Parkwood Institute Mental Health Care Building
Part IV: The House (Inpatient Unit) -- Virtual Tour of the Parkwood Institute Mental Health Care Building Deb Corring, Director, Mental Health Care, and Cameron Shantz, Principal, Parkin Architect...
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Obama #39;s New Surgeon General: Gun Control Is A Public Health Issue
The Senate had voted against Dr. Vivek Murthy becoming the next Surgeon General once before. Murthy believes that guns make for a health care issue and wants gun control. It seems that Democrats, ...
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Innovation in social services
Rick Steele is a highly qualified clinician as (M.D., M.P.H., P.D.C., B.C.S.P.H.M.) in acute and internal medicine, http://goo.gl/zwRzIB but also a public health specialist and educator. He...
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Transforming Medicine: The Role of MDMA in Mental Health Care
MAPS Founder and Executive Director Rick Doblin Ph.D., and MDMA-assisted psychotherapy for PTSD investigators Dr. Michael Mithoefer and Annie Mithoefer, B.S.N. speak about their current ...
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Global Health Market Shaping Forum: Discussion of the Practice and Potential
Global health is inextricably linked to the health of the marketplace that delivers lifesaving products to low-income populations. A well-functioning health care market requires manufacturers...
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NEW YORK (CNNMoney)
Google (GOOG)'s VC investment arm is doubling down on life science and health service startups. This means everything from digitizing primary care (One Medical) to cloud-based genome data (DNA Nexus). It's the first year that the majority of the fund's investment dollars have been in this sector (36%), followed by mobile (27%) and consumer startups (8%, down from 66% in 2013).
"It's not surprising at all to me that we, as investors, are interested in [the space]," said Bill Maris, managing partner at Google Ventures. "36% of our dollars invested doesn't seem like a huge number. I feel like we could probably do more."
It is, however, a significant increase.
In both 2012 and 2013, funding for life sciences and health startups made up just 9% of their total.
Google Ventures' portfolio includes companies like Nest (since acquired by Google), Blue Bottle Coffee Co., DocuSign, and, of course, infamous transportation disruptor Uber.
Related: Google searching for cancer cure
Overall VC funding mirrors this trend. According to data from PrivCo, funding to health care and life sciences startups jumped by nearly $8 billion from 2013 to 2014, capturing $20.7 billion. It's followed by commerce ($18.7 billion) and mobile ($13.9 billion).
According to Maris, his firm placed a "concerted effort" on funding fledgling startups in the life sciences. ("If we don't, who's going to?" he said.)
Maris -- who helped bring on genetics expert Andrew Conrad to head up Google X's Life Sciences team -- recalls getting criticized for their focus early on.
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Google Ventures: less Ubers, more health care - Dec. 16, 2014
Health care is ripe for innovation, especially in the realms of health care services and information technology (IT). This situation is one of the main reasons there has been such impressive growth in digital health funding over the past few years. However, much of that investment and many new companies in the health care delivery [1] space are not truly adding value or addressing fundamental problems.
Having worked in health care from both the business and clinical perspectives, I've heard countless companies -- big and small -- talk about revolutionizing health care. Many of the newer companies even use the word "disrupt," borrowing from the concept of disruption made famous by author and Harvard Business School professor Clayton Christensen. Let's clear up what disruption actually entails. The below graphic highlights the key points.
In disruption, an innovation starts by providing a meaningful but lower value service than what currently exists, thereby creating a new market of customers who were previously not served. A recent example of disruptive technology would include the iPad as compared to traditional laptops. As disruptive innovations evolve, they climb the performance value chain. Ultimately, they can become the preferred service/technology and displace the incumbent -- or at the very least take significant market share.
In New York and several other major cities, Uber has disrupted the taxi industry by providing a more convenient service often at a lower price than standard taxis, recent legal action and surge pricing notwithstanding. Recently, I became aware of Pager, a New York-based company started by one of Uber's co-founders, Oscar Salazar, as well as a similar company in South Florida named Medicast. Both have been profiled on CNN and are trying to bring back the storied concept of the doctor house call -- albeit for the concierge market. In late October, Uber began a partnership with Pager for its own UberHealth initiative.
As a practicing physician with several years of clinical experience, I can say that there are only a small number of illnesses I can treat confidently without referring a patient for basic labs, imaging, or monitoring. House calls traditionally had the most benefit in rural/underserved locations where access to health care is limited -- not in major cities with ample resources. Furthermore, in a major metro area like NYC, there is no shortage of urgent care centers and retail clinics with late hours that offer a wider array of services for the $199 price tag of a house call. Although it may be possible to generate revenue, serving a concierge population with a lower value service is hardly disruptive. And in the broader context of health care, it does not address a major problem, lower costs in the long run, or improve societal health. So those issues leave me asking, what benefit does the premium option of a house call have beyond convenience? How does it truly advance health care or fulfill an unmet need?
The aforementioned questions got me thinking about the broader topic of recent health care innovation. When we think about U.S. health care economics, it's important for people to realize that 1 percent of the population accounts for more than 20 percent of overall health care spend (and an average annual mean expenditure greater than $90K per patient), with the top 5 percent of health care users representing almost 50% of health care expenditures [2]. Given that current health care spending is approximately $2.9T (and more than 17 percent of the nation's GDP), 5 percent of the population currently requires almost $1.5T of health care resources. High intensity users of health care are those with chronic illnesses, and often elderly. Per the Agency for Healthcare Research and Quality (AHRQ), they likely have some combination of heart disease, trauma-related disorders, cancer, mental illness, and asthma/chronic obstructive pulmonary disease (COPD). In addition, these patients receive care in the inpatient setting far more frequently than the general population.
To improve health care dramatically and bend the cost curve, entrepreneurs and innovators need to help create better methods to treat the chronically ill and utilize health care resources more efficiently. Further upstream, they also need to identify those most at risk and help them maintain health. In a recent Wired article by J.C. Herz titled "Wearables Are Totally Failing the People Who Need Them Most," Herz discusses how the wearables [3] market is insufficiently focused on the elderly and chronically ill who could benefit most from such medical technology. One particular line from the article was rather scathing:
From Silicon Valley and San Francisco to Austin and MIT, young, healthy, highly educated, mostly male entrepreneurs are developing marginally useful apps and gadgets for people just like themselves.
Clearly there are some health care startups that will meaningfully improve health care. But there is justifiable concern that too many are focused on the wrong patients and wrong problems using technology with limited applicability.
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SACRAMENTO -- California's health care exchange has exceeded last year's insurance sign-ups during its first month of open enrollment as it nears a deadline for coverage to begin Jan. 1, Covered California Executive Director Peter Lee said Wednesday.
More people chose a plan in the first month than in the first two months of open enrollment last year. More than 144,000 residents have selected Covered California plans this year on the marketplace, which was created as part of President Barack Obama's health care reform law.
The exchange has extended its former deadline from Monday to midnight this Sunday for consumers to get new insurance or change insurance plans in time for coverage to take effect with the new year.
The exchange is on pace to beat its goal of enrolling 1.7 million people for private health coverage next year, including re-enrolling 1.1 million people who signed up the first season, Lee said in a conference call with reporters.
"These numbers are incredibly strong and bode well for California," he said.
More than 592,000 residents have been deemed eligible for private health insurance or Medi-Cal, California's version of Medicaid, the government health insurance program for the poor and those with lower incomes. That includes more than 216,000 enrollments and nearly 75,000 deemed likely to be eligible for Medi-Cal coverage. Medi-Cal, which is open for enrollment year round, has enrolled more than 2.2 million consumers this year.
More people may be signing up because they are more comfortable now with a law that "has been a little bit of a political football," said Nicole Kasabian Evans, a spokeswoman for the California Association of Health Plans, which represents health insurance companies.
"We now have a proven track record after a year, so those who might have hesitated in year one are ready to jump in," she said. "People got their care, they could go to the doctors, they got their coverage. It has been delivering."
The exchange extended a deadline to Sunday for consumers to get new insurance or change insurance plans in time for coverage to take effect with the new year.
On Monday alone, the previous deadline, more than 25,000 people completed enrollment, Lee said. The goal is to get help in particular for the more than 157,000 who completed the application process and were deemed eligible, but who must select an insurance plan this week for their coverage to begin Jan. 1.
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Health care exchange extends deadline; sign-ups continue to exceed this time last year
Calling it the biggest disappointment of his career, Gov. Peter Shumlin said Wednesday he was abandoning plans to make Vermont the first state in the country with a universal, publicly funded health care system.
Going forward with a project four years in the making would require tax increases too big for the state to absorb, Shumlin said. The measure had been the centerpiece of the Democratic governor's agenda and was watched and rooted for by single-payer health care supporters around the country.
"I am not going (to) undermine the hope of achieving critically important health care reforms for this state by pushing prematurely for single payer when it is not the right time for Vermont," Shumlin said to reporters and two boards advising him on health care changes.
Legislation Shumlin signed in 2011 put the state on a path to move beyond the federal Affordable Care Act by 2017 to a health care system more similar to that in neighboring Canada. Shumlin adopted the mantra that access to quality health care should be "a right and not a privilege."
The legislation called for the administration to produce a plan for financing the Green Mountain Care system by 2013 but it wasn't completed until the last several days. Shumlin said it showed the plan would require an 11.5 percent payroll tax on businesses and an income tax separate from the one the state already has of up to 9.5 percent.
Shumlin said small business owners would be hit with both, and he repeatedly expressed concern about whether those businesses, many of which now don't offer health insurance or offer much less costly insurance, could cover the new expense.
The governor said he had asked his health care team for alternative designs, but no one could come up with a plan to offer quality coverage at an affordable cost.
"The bottom line is that, as we completed the financing modeling in the last several days, it became clear that the risk of economic shock is too high at this time to offer a plan I can responsibly support for passage in the Legislature," the governor said.
He said that was especially true at a time when the state has not fully recovered from the recession and has seen recent revenue forecast downgrades of $75 million. In addition, Shumlin's health care team concluded the state would get $150 million less in federal help with the health care changes than anticipated earlier, and an additional $150 million less in Medicaid assistance.
The decision was welcomed by some members of a Business Advisory Council that Shumlin had appointed to provide feedback on proposed health changes.
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In 2002, a landmark Institute of Medicine report awoke the world to shocking inequality in the health-care system. The report's conclusion: racial and ethnic minorities tend to receive lower quality of care than whites do, even after accounting for factors like income and insurance status.
The reasons for the disparity were complex and varied. The IOM pointed to differences in how minorities sought out health-care services, uncertainty amongdoctors on diagnosing and treating patients from different racial or ethnic backgrounds, and how health systems were financed and designed, among other reasons.
So how does this translate to the real world? It means if you're a white patient entering a hospital, you're more likely to get certain treatments than black and Hispanic patients are. For example, about a decade ago, 43.4 percent of white patients coming into the heart attack received an angioplasty within 90 minutes of entering the hospital, compared to just 29.2 percent for black patients and 34.1 percent for Hispanic patients.
That's one of the pretty stark findings from a recent New England Journal of Medicine study, which actually uncovers encouraging evidence that hospitals are reducing racial disparities in care. Reviewing more than 12 million hospitalizations between 2005 and 2010, researchers set out to find whether hospital quality was improving and whether minority groups were still being left behind.
By 2010, angioplasty rates for all heart attack victims rose dramatically as the disparity gap also narrowed, according to the study. That year, 91.7 percent of white patients received the procedure within 90 minutes, compared to 86.3 percent of blacks and 89.7 of Hispanic patients so the treatment gap between whites and blacks was cut by more than half in those five years.
The researchers found more progress than that, though. Looking across 17 quality measures for heart attacks, heart failures and pneumonia, researchers found that racial disparities were reduced in every category between 2005 and 2010. Importantly, they found hospitals were providing care more equally within hospitals, as well as between hospitals meaning hospitals that serve higher rates of minority patients also saw improvements, the study authors wrote.
Meanwhile, another new analysis from the Urban Institute shows how the the Affordable Care Act's coverage expansion is narrowing the health insurance gap. The think tank projects that the Hispanic uninsured rate, the highest among any ethnic group, will drop from 31 percent to 19 percent by 2016, and the uninsured rate for blacks will drop from 20 percent to 11 percent.
As the above chart highlights, the coverage gains for minority groups would be even greater if every state expanded their Medicaid programs. As of Jan. 1, 27 states and Washington, D.C., will have accepted the ACA's Medicaid expansion, while three more governors are asking their legislatures to approve the program in 2015.
Most significantly, the NEJM and Urban studies indicate that our health care system is getting more fair.
Jason Millman covers all things health policy, with a focus on Obamacare implementation. He previously covered health policy for Politico.
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Wonkblog: The huge health care gap between whites and minorities is starting to narrow
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Health care stocks were finishing much higher today with the NYSE Health Care Sector Index climbing 1.7% and shares of health care companies in the S&P 500 moving 1.9% higher as a group.
In company news, shares of Vermillion Inc. ( VRML ) were in the red Wednesday after the biotech company developing prospective treatments for gynecologic disease late yesterday said it was promoting Chief Operating Officer Valerie Palmieri to president and CEO, effective with the start of the new year.
Current CEO and board chairman James LaFrance will continue to serve as chairman following the upcoming change-over.
Although Palmieri has only been chief operating officer at VRML since October, she was a strategic consultant with the company during the prior six months. She previously was CEO at two health care startups as well as senior positions at Dianon Systems and later LabCorp after Dianon's acquisition.
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Vermont Gov. Peter Shumlin on Wednesday dropped his plan to enact a single-payer health care system in his state a plan that had won praise from liberals but never really got much past the framework stage.
This is not the right time for enacting single payer, Shumlin said in a statement, citing the big tax increases that would be required to pay for it.
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Shumlin faced deep skepticism that lawmakers could agree on a way to pay for his ambitious goal and that the feds would agree to everything he needed to create the first state-based single-payer system in 2017.
And that was all before Shumlin, a Democrat, almost lost reelection last month in one of the countrys most liberal states. And it was before MIT economist Jonathan Gruber, the now notorious Obamacare consultant who also advised Vermont until his $400,000 contract was killed amid the controversy, became political poison.
Shumlin had missed two earlier financing deadlines but finally released his proposal. But he immediately cast it as detrimental to Vermonters. The model called for businesses to take on a double-digit payroll tax, while individuals would face up to a 9.5 percent premium assessment. Big businesses, in particular, didnt want to pay for Shumlins plan while maintaining their own employee health plans.
These are simply not tax rates that I can responsibly support or urge the Legislature to pass, the governor said. In my judgment, the potential economic disruption and risks would be too great to small businesses, working families and the states economy.
And that was for a plan that would not be truly single payer. Large companies with self-insured plans regulated by ERISA would have been exempt. And Medicare also would have operated separately, unless the state got a waiver, which was a long shot.
Shumlin added that federal funds available for the transition were $150 million less than expected.
He also has a lot less political capital than before November. Shumlin, chairman of the Democratic Governors Association, still hasnt even officially won his own reelection bid: The Legislature will settle the outcome of the November race in January because Shumlin failed to win more than 50 percent of the vote. Hes leading his Republican challenger by just a few thousand ballots.
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PUBLIC RELEASE DATE:
17-Dec-2014
Contact: George Hunka ghunka@aftau.org 212-742-9070 American Friends of Tel Aviv University @AFTAUnews
Premature ovarian failure, also known as primary ovarian insufficiency (POI), affects 1% of all women worldwide. In most cases, the exact cause of the condition, which is often associated with infertility, is difficult to determine.
A new Tel Aviv University study throws a spotlight on a previously-unidentified cause of POI: a unique mutation in a gene called SYCE1 that has not been previously associated with POI in humans. The research, published in the Journal of Clinical Endocrinology and Metabolism, was led by Dr. Liat de Vries and Prof. Lina Basel-Vanagaite of TAU's Sackler Faculty of Medicine and Schneider Children's Medical Center and conducted by a team of researchers from both TAU and Schneider.
While the genes involved in chromosome duplication and division had been shown to cause POI in animal models, this is the first time a similar mutation has been identified in humans.
A new insight
"Researchers know that POI may be associated with Turner's syndrome, a condition in which a woman has only one X chromosome instead of two, or could be due to toxins like chemotherapy and radiation therapy," said Dr. de Vries. "However, in 90% of the cases, the exact cause remains a mystery."
The idea for the study surfaced when Dr. de Vries was asked to treat two POI patients, daughters of two sets of Israeli-Arab parents who were related to each other. The girls presented with typical POI symptoms: one had the appearance of puberty but had not gotten her period, and the other one had not started puberty at all. After ruling out the usual suspects (toxins, autoimmune disease, and known chromosomal and genetic diseases), the researchers set out to identify the genetic cause of POI in the two young women.
"One of my main topics of interest is puberty," said Dr. de Vries. "The clinical presentation of the two sisters, out of 11 children of first-degree cousins, was interesting. In each of the girls, POI was expressed differently. One had reached puberty and was almost fully developed but didn't have menses. The second, 16 years old, showed no signs of development whatsoever."
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By: Angelica Nino
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In a blog post, Neal Stephenson says it's time that people develop a new medium, "one in which three-dimensionality is a reality and not just an illusion laboriously cooked up by your brain." Madeleine Ball/NPR hide caption
In a blog post, Neal Stephenson says it's time that people develop a new medium, "one in which three-dimensionality is a reality and not just an illusion laboriously cooked up by your brain."
It seems we have a new case of life following art. Over two decades ago, in his seminal novel Snow Crash, science fiction author Neal Stephenson imagined a virtual world he called a "metaverse," a collective virtual reality that brought its users together in a single shared space. Now, Stephenson is trying his hand at helping sculpt another kind of alternate realitythis time not in print, but in life at large.
Stephenson announced that he will be joining the startup Magic Leap as the company's "chief futurist." While the company itself remains something of a mystery, the Wall Street Journal reports that "the startup is developing its own eyeglasses-like device, different from Google Glass, designed to project computer-generated images over a real-life setting." In other words, the technology is said to try to blend seamlessly what's real with what's virtualnot unlike some of the technologies in Stephenson's book.
Though the company has yet to produce anything, Google and several other tech titans have been big backers of the project, to the tune of $542 million in investments.
In a blog post for Magic Leap, Stephenson said his role will not be concerned with business or science, so much as with how to apply the product once it's ready.
"I'm fascinated by the science, but not qualified to work on it. Where I hope I can be of use is in thinking about what to do with this tech once it is available to the general public," Stephenson wrote. "'Chief Futurist' runs the risk of being a disembodied brain on a stick. I took the job on the understanding that I would have the opportunity to get a few things done."
The Punch and the Publisher: Former Minnesota Gov. Jesse Ventura has turned his sights on the publisher of the book American Sniper. According to the StarTribune, Ventura has filed a lawsuit against HarperCollins for alleged defamation of character.
In his best-selling memoir, the late Navy SEAL Chris Kyle told of a scuffle he had with Ventura, whom he identified by the name "Scruff Face" in the text. Kyle wrote that he had punched Scruff Face over disparaging comments the man had made about the United States and the Navy SEALS. After the book's publication, Kyle explained that Scruff Face and Ventura, who is also a Navy veteran, were one and the same.
For his part, Ventura disputes this claim, saying the incident actually never happened. And he's already won a $1.8 million lawsuit against Kyle's estate over the same story.
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Book News: Sci-Fi Writer Signs On As 'Chief Futurist' For Secretive Startup
Shakir Hamoodi #39;s family looks forward to his freedom
KRCG 13 For more information, visit http://www.connectmidmissouri.com/ Like us on Facebook! http://www.facebook.com/krcgtv/ Follow us on Twitter: http://twitter.com/KRCG13/
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Freedom! has promotional power
How did George create a large surge of views to an older video? Let #39;s find out! Get your own Video CMS and website!
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Dejlige Freedom, flot fremvist af Malene 🙂 Freedom er til salg...... Henvendelse : Margit , 20233351.
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