Sadly, the quicker response by insurance companies will be to find more clever ways to cancel people that cost them money. Insurance companies make money by rejecting risk - keeping people healthy is not one of their 'core competencies'.

If we cannot reach a consensus on the role of voluntary community based charity care, versus forced tax based subsidies, we will devolve into a mandatory state and federalized single payer system, with all the benefits that entail. I don't know why people think care and treatment review by government bureaucrats will be any better than review by insurance companies.

Has anyone considered implementing health savings plans either individually or at their place of business as a means of saving dollars on healthcare? Rather than currently paying a low deductible but, a much higher monthly premium for health insurance, this model would shift more control to the insured and incentify them into making better decisions regarding their health by having a financial stake in the funds used to pay for it. Employers who would see a significant drop in premiums could actually put the cost difference in savings into a raise for all of their employees to help cover their new higher deductible.

The deductible would increase for example to $2,000 per insured. The health insurance companies would benefit because a higher deductible would result in a lower premiums and less risk cost burden for annual health maintenance making health insurance less expensive for everyone. The physician's offices could benefit because the cash deductible/savings could be paid directly out of the health savings account to their offices for services and therefore could reduce their AR days and increase cash flow.

Savings put into the plan but, not used for health coverage would be the insured's to keep tax defered as another retirement savings vehicle. I am suprised that this insurance model has not been discussed or implemented more often as a vehicle for reducing the cost of healthcare while benefiting the insurer, insured and the provider.

Tom:

Thanks for the confidence! Comparing the present to the 2000 tech & private equity meltdown, I would agree that the situation today is much worse as it is affecting the core of business continuity on an already shakey federal fiscal budget.

But every dark cloud has a silver lining. As you aptly point out that areas of interest previous thought unnecessary may show-up sooner than we think. EMR companies are already thinking about monetizing strategy over clinical strategies and engaging physicians in a colloborative rev share model for higher billing & reimbursement models. Pharmaceutical and therapeutic firms are eyeing provider groups to procure opt-in trial enrollments for patients. And concierge & drop-in health models like MDVIP and MinuteClinic are popping up everywhere around us.

If we think about all the ways in which provider organizations can leverage various tools to make money, there may be some tough choices ahead. I am already seeing the prioratization metrics for projects in some larger provider org's changing significantly as the value sought is towards sustaining their business than enhancing practice experience for the care givers.

That means there is a lot to do for all us. From increased reporting and metrics that monitor our growth areas and address inefficiencies to addressing patient needs before a acute episode occurs - this is a role that we as patients and care givers have to fulfill.

Lastly, the promise of Personalized Medicine is overwelhming. Like any new scientific breakthrough, I am not looking at genetics as the pixie dust solution that will make us healthy and save organizations millions - rather as an area that needs more attention than it has been given lately and work towards operationalizing the power of genetic data. Like the classic Long Term Equilibrim Curve model, there might be decreased returns now while we figure this area out, but inevitably - this might just be the default care standard 10 years from today that all of us will be working on. And as first movers in this space, this could well be a pure capital play for organizations dedicated to Personalized Medicine.

Aloha

...and greetings from Maui where we're mapping a Connecting Care system -a digital bridge between
in-home patients, familiy caregivers, and healthcare providers.

We'll soon be implementing a mini-pilot test of our system to obtain some cost/benefit parameters for a larger test in early 2009. We've decided to carry on and invest in this project because we believe our community urgently needs the connected care system we envision AND payers need postive health and cost/benefit outcomes before they'll begin paying for any of the innovative in-home telecare tools that are available now.

The economic downturn is likely to last for a few years, meanwhile 75 million baby boomers are yearning to age in place, burdened by caregiving, and experiencing chronic diseases.

Our Connecting Care model will help the age wave to age in place, proactively manage their health and wellness issues and save them and healthcare payers a grerat deal of money in the future.

We recommend that visionaries and vendors alike stay the course. The wind will come around behind us with time.

Peter Durkson, EdM
www.mauiagewave.com

Thanks for the insightful commentary, Dr. Lee. While I agree with others that this may not totally be the tipping point we need, the current financial crisis will certainly draw more attention to the fact that technology can be applied to make health information and certain medical services more accessible and affordable. Just today, I received information about an on-line company that is making prescription eyeglasses available for as little as $7.95 a pair. We need more competition in health and more free market choices. We need a revolution in medical education if we ever hope to have enough providers to meet demand. Our current system doesn't scale. I recently posted a short video commentary on my blog, HealthBlog (http://blogs.msdn.com/healthblog) that explores how appropriately applied technology and changes to the way providers are reimbursed can get us moving in the right direction. The direct link is here: http://blogs.msdn.com/healthblog/archive/2008/09/29/the-economic-crisis-and-healthcare-reform.aspx

Bill Crounse, MD
Senior Director, Worldwide Health
Microsoft Corporation

If ever there was a time for "connected health" to prove its value, that time is now.

It is precisely when the current U.S. "system" is starkly shown to be unaffordable, unsustainable, inefficient, prone to error and inequitable that the way is most clearly paved for new approaches like connected health to demonstrate their historic claims.

Since at least 2006, we have witnessed a "Coperenican revolution" in healthcare, disproving the twin American beliefs that "all healthcare is local" and that "the United States has the best healthcare in the world." The emergence of new, nationally-branded, retail-oriented, electronically-connected, primary care "ports of entry" have begun to restructure a hospital- centered and specialty-dominated system that has continuously been built "upside down," since the end of Word War II, the passage of Medicare legislation and the growing economic impact of leaving 1 out of every 6 American residents medically uninsured.

If, instead of relying upon the grant-supported initiatives of the past 50 years, connected health took its technology and services to the real medical marketplace, we might see a healthcare revolution as profound as that which followed Copernicus' revolutionary astronomical theories nearly 500 years ago.

Ronald L. Hammerle
Chairman and CEO
Health Resources, Ltd.
Tampa, Florida

Dr. Lee,
Thank you for posting your thoughts. My observation, from Main Street, while looking at the growth of our consumer subscription revenue in the last month is that you are entirely correct. Our business is flourishing.

Nat Findlay
CEO
Hello health , Inc.
Brooklyn, New York