I have an ongoing interest in healthcare.
I did some Work Process consulting for Glendale Adventist Medical Center in 1985.
I was an internal consultant (Management Engineer) for New York Hospital in 1988-89.
I worked for Scp Communications, a medical journal publisher and events manager, in 1992-93.
I helped start Med Scape, 1994-2000.
I was going to join a Complementary Medicine (Alternative Health) startup in 1999, but they failed to get funding.
I'm still tempted at times to start a narrow-topic (probably something psych-oriented) healthcare content/community website. I may do it as a side business some time in the future. Might take a Nono Publishing approach of combining a Web Log and a Vertical Search Engine.
looks like Health Line beat me to it!
Some factors:
- demographic shifts (increasing age) will significantly increase costs
increasing Chron Ic Condition-s will significantly increase costs
US system is optimized for hospital-based care of acute problems
- this doesn't fit with growing areas of demand
increasing care by lower-skilled professionals, Amat Eur-s, family-members, and self will be increasingly important
Trade Guild forces are fighting against this
Some things broken:
employers get to deduct their expenses of providing Health Insurance, but individuals can't deduct the cost of insurance they buy themselves. (Tax Deduction)
the prices to buy Health Insurance as an individual Free Agent are obscene. Does risk-averaging really provide a benefit to insurers handling a corporation? That just doesn't smell right. (Group Purchasing)
if as a Free Agent you focus on a Catastroph Ic policy (because, after all, it's pretty silly to buy "insurance" to cover standard physician visits), then you pay a ridiculous fee for doctor visits (if you're an HMO member, you pay $15 and the HMO pays maybe another $45; go alone and you pay over $100). (Group Purchasing)
we focus on benefits for Senior Citizens, yet they have much more wealth than children - I think we need Means Testing for Social Security, Medi Care, and everything else.
just because medical technology makes certain interventions possible, that doesn't mean it's a good idea for the individual. While I'm OK with letting them make that choice for themselves, I'm not convinced the rest of us need to pay for it.
many late-life health issues are a direct result of personal Life Style decisions: Smok Ing, excessive alcohol (Drink Ing), sedentary life (Obes Ity), super-fatty diets, etc. Why should the rest of us bear the burden of bad Physical Fitness choices?
Arnold Kling on using Reputation Management instead of Paternal Ism - he notes Drug Regulation issues, I think Mal Practice would be interesting.
Oct'2004 update - applying it to Trade Guild Work Rules. Although medical work rules serve primarily to carve out economic rents for health care providers, they are not sold that way to the public. Instead, these regulations ride in under the banner of "consumer protection."
I think EHealth systems (e.g. EMR) are being mis-designed as overly-scoped messes, rather than be focused on specific areas of problem, like Medical Error-s, that can be attacked by specific behavior changes (e.g. Online Prescribing).
http://www.nlm.nih.gov/nichsr/ihcm/hsrchist.html
http://www.panix.com/~dhenwood/Paying-for-health.html
books on the future:
covered by Med Blog-s