HEALTHCARE & MEDICARE

Why Multiple Vehicles Need Two Health Systems, Not One – Health Care Blog

Jeremy Shane

What’s behind the upcoming health care estimate? Most industry leaders have their preferred culprit: not us! Left-leaning critics accuse large insurance companies, pharmaceutical companies and private equity firms. Profit and self-delivery from healthcare. Those on the right blamed excessive regulation, poor insurance markets, or restricted individuals’ ability to choose their own coverage. The debate between these views amid a political impasse. Although these views are for solutions, they believe that financial problems are the root cause of systemic dysfunction. Manipulating clinician salary or insurance is a structured way to improve health outcomes.

Half a century of hard work to fix health care, it is clear that both views are wrong. Healthspans in Americans are shrinking due to chronic diseases and costs are rising. The disease that gradually worsens throughout adulthood eventually explodes in frequent occurrences, driving cancer and dementia, and protracted hospitalizations. Clinicians know this with an old chorus of “only” lamenting. If we can reward prevention rather than treatment. If we only intervene before advanced pathology. If clinical care is not dispersed only. If only people have direct shares in long-term health. However, the debate in Washington, D.C. is even stunned by the Maha movement’s focus on chronic issues, returning to the infinite game of blame, and ambivalent ideas about how Congress or CMS ends the madness.

It’s time to break the cycle and clearly state the scientific facts we know. It is impossible to use built systems to solve acute problems, but also to solve highly variable disease threats from years ago. However, this assumption is that a system can do it all, solving everything from colds to car accidents to cardiovascular problems to cancer, and our minds are deeply rooted in order to avoid scrutiny.

It's stupid to keep moving forward. We need two systems, not one – the first system of conventional, emergency and elective courses, and the second system faces long-term, complex challenges. Without this change, it will take much longer than it should and will take more time to decipher chronic problems or create economic arrangements, thus bringing the ultimate value of preventing disease.

Reset assumptions

Focusing on the scientific drivers of disease rather than the impact after finance is illuminating. It's obvious why Medicare Advantage exploded, no, not because CMS changed the payment rate. Since 2000, the percentage of Americans entering a variety of Americans has increased by two-thirds from one-quarter of new entrants to more than 40%. Software may be eating the world, but a wide variety of people are eating Medicare, Medicaid, and private insurance, while most Americans have health care services.

Nowadays, most Americans live a decade more than their grandparents, only spending years on their health.

There are more years of living, but years of good health are hardly cheap. People who narrow down their health impose huge socioeconomic costs, slowing workers’ incomes (due to higher premiums and copayments), while requiring greater health spending in the workforce and retirement. Combined, these trends constitute the most attributable tax on the wealth of middle-income and poor Americans. Addressing multiple diseases that increase health conditions will be the largest and most progressive policy that can unlock $15 trillion or more for Americans over the age of fifty. Most of these gains will earn middle-income Americans, which are liberals, incompetent centrists of loved ones, Maha activists and low taxes, freelance marketers should all gather.

Ironically, no agency tracks HealthSpan or sets goals to increase goals. Therefore, health debate is shaped by statistics collectincluding total expenditure and life span, although both indicators are the result of upstream selection rather than leading indicators and misleading. For example, consumption data reflect inefficiency and inequality caused by the use of acute care systems to address long-term problems, thereby gradually increasing treatments to keep pace with accelerated pathology. Life expectancy indicators also portray incomplete circumstances, reflecting the disproportionate effects of prenatal and postnatal care in adolescents and young adults and high accident and addiction-related mortality rates. All of these issues are worthy of attention and resources, but even magically erased, it will not help, and can reverse the source of greater disease burden, costs and systemic dysfunction.

The HealthSpan indicator will illustrate the magnitude of chronic disease prevalence over time, providing early indicators for future disease risk and expenditure. Instead of looking at the spending of the population segment, we will track the number and types of conditions between the population segments (i.e., zero, one, two, three, etc.). This allows us to move from a static snapshot of chronic diseases to a more dynamic view, illustrating the changes in incidence and prevalence and the speed of disease combinations. When the widely respected Rand Institute studied the issue in 2017, it was found that 30% of Americans with a diversified vehicle rate accounted for two-thirds of total health spending. Another 30% have one or two conditions, and the remaining 40% of unspecified portions may be at risk of future illness.

These statistics highlight how the burden of disease becomes a burden of disease as chronic diseases develop into multiple diseases. The pathways in a person's lifespan are more like cascades than a series of different diagnoses. It is a decades-long war of loss, influenced by innate and environmental factors, over time, pathology accumulates, internal defenses, spills from one organ or system to another, gaining momentum from age-related transgender, while eating.

Therefore, it is meaningless to discuss the relative value of treatment and prevention. We must do both, work at all stages of the chronic disease cascade, reverse those with the disease, help everyone maintain a better trajectory of health, and expand efforts to predict future risks and prevent attacks.

Efforts to increase health can also be absolutely measured to see the median age of multiple incidence and multiple episodes in those entering Medicare. The first tells us whether we are making progress in delaying the chronic disease cascade, while the latter tells us whether we are doing this on a large scale. All of these indicators can also be sliced by demographics or other factors and understand the correlation of timing or severity of conditions that more or less cause multiple multiples.

This brings us back to the core of today’s systems, especially health insurance. Much of the value of the system is to stop future diseases, whether more expensive or cheaper interventions are needed. However, the fees we pay for health coverage are hardly preventing future disease risks. Some parts provide coverage for low-frequency, high-cost events such as trauma accidents, but most premiums are an annual prepayment plan that provides access to clinicians and hospital networks. Most of these funds are used to treat incremental symptoms, especially as we have seen before, for advanced multiple diseases.

The system is completely contrary to what should be done, underestimated near-term interventions, while more cost-effective, may have better long-term impacts, while prioritizing expensive treatments for advanced disease with lower long-term ROI. There is no way to reward payers, clinicians or individuals to achieve better long-term results, nor to propose future value of predictive or preventive efforts, quantify and explore the value that avoids disease over time.

Use life insurance to address multiple illnesses and increase health coverage

Despite all the questions, is it possible to build a new system for chronic diseases?

Yes, if we are strategic about this, we focus on metabolism first. It makes sense to start from here, because metabolic problems are an important contribution to the risks of multiple factories, cancer and dementia, as well as a huge advance in therapeutic medical technology. GLP-1 drugs are game-changing, offering systemic value beyond obesity and diabetes, and appear to improve only as new combination therapies develop. This is the case except for the already effective surgical methods. Neither silver bullets, both require overall clinical expertise and ongoing medical and behavioral support, but we can now confidently say that it is possible to reverse metabolic disease.

To support this, we need a financial framework that enables individuals, clinicians and insurers to achieve long-term outcomes that not only treat disease, but also help people sustain decades of gains while accelerating the ability to predict and prevent disease.

That's why the correct financial structure to correctly solve chronic diseases is life insurance. Its long-term investment scope enables investment to reverse or prevent disease plus ongoing efforts to retain returns and predict future illnesses. Health insurance is concentrated in places where the cost of input is invested, and life insurance relies on the stable accumulation of good results. The tactical cost to use in any given year is less than the benefits generated over the years.

This is a revolutionary change that allows everyone (individuals, payers, clinicians and product manufacturers) to revolve around the results over time and share the value of lower health spending. Most importantly, life insurance provides a mechanism that rewards individuals for their progress in improving their health trajectory. Individuals can earn payments related to health goals that can be deposited into the savings portion of the policy to increase tax exemption. Verifying individual progress will require consistent approaches to collect longitudinal medical and non-medical data, including blood samples, supercharge efforts to develop and validate predictive and preventive measures.

Using what we think of as products to protect early deaths to increase health is a profound shift in the reimagining. But, given that the disease threat will slowly kill and then kill all at once, it makes sense. About a decade ago, the visionary Clayton Christensen (and his co-author) wrote in the Innovator’s Prescription that the ideal entity that undermines existing systems is:

“…A dominant profit formula makes money by keeping us healthy, not only by making us healthy. It must be a person’s tenure long enough to spend more money when necessary, when necessary, to save higher costs. It must be a system that can motivate to spend what is needed, so it must be a waste of money, but it must also be wasted.

Deprive chronic treatments through sick leave care and repackaging it with life insurance, hooking all four of Christensen's boxes. In future posts, we will look at how to build a new system. For now, the circular debate that is sufficient to realize the status quo and its existing businesses encourage is not static. There is a viable option; if we are willing to think beyond existence, we can escape what is holding us back.

Jeremy Shane has a career in consumer health technology (including serving at HealthCentral and WebMD) and energy. He is currently a researcher at the USC Schaeffer Center for Health Policy and Economics.

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