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A Review of An Illustrated Guide to Personal Health by Al Lewis

Al Lewis wrote a review of my new book, An Illustrated Guide to Personal Health on his excellent blog called THEY SAID WHAT? BECAUSE THE WELLNESS INDUSTRY’S PANTS ARE ON FIRE.  Click here to read full review. Al wrote, “A company wanting to replace the advice given

About Cracking Health Costs

Dear Readers of Cracking Health Costs, I’ve just published on Amazon a new book called An Illustrated Guide to Personal Health, co-authored by Roberts H. Woods, PhD, an excellent researcher and professor at UNLV. This book is aimed at showing consumers how they can improve their health and

Cancer drugs aren’t just really expensive; they’re a bad value

That stunning headline is from a Washington Post article. The author is Carolyn Johnson. Writes Carolyn, “With some cancer drug prices soaring past $10,000 a month, doctors have begun to ask one nagging question: Do drug prices correctly reflect the value they bring to patients by extending

Show Wellness Isn’t an Epic Fail and Collect a $1-Million Reward

The title above is an offer made by my friend and coauthor of our book, Cracking Health Costs, Al Lewis. As regular readers of this blog know, I’ve always been doubtful that company-sponsored wellness is effective in a way that does not produce a negative ROI. The recent

iDoctor: wave of the future? Let’s hope.

“Medicine today is currently set up to be maximally imprecise” says Dr. Eric Topol. Regular readers of Crackinghealthcosts.com will understand that comment. Topol, one of the world’s foremost cardiologists, has been a bit of a gadfly to big Pharma and the medical profession. He discusses

A Review of An Illustrated Guide to Personal Health by Al Lewis

Al Lewis wrote a review of my new book, An Illustrated Guide to Personal Health on his excellent blog called THEY SAID WHAT? BECAUSE THE WELLNESS INDUSTRY’S PANTS ARE ON FIRE.  Click here to read full review.

Al wrote, “A company wanting to replace the advice given on health risk assessments with actual good advice need look no further than An Illustrated Guide to Personal Health, by Tom Emerick and Robert Woods.”

Further, “…An Illustrated Guide is easily digestible, fun to read and in terms of health, the perfect antidote for the stress caused by pry-poke-and-prod wellness programs.”

 

Tom Emerick

Tom’s latest book, “An Illustrated Guide to Personal Health” is now available on Amazon.

P.S. My first published book, Cracking Health Costs, co-authored with Al Lewis, was an Amazon trade best seller thanks in part to your support and was aimed at health and benefits professionals. Again the new book is for consumers.

About Cracking Health Costs

Dear Readers of Cracking Health Costs,

I’ve just published on Amazon a new book called An Illustrated Guide to Personal Health, co-authored by Roberts H. Woods, PhD, an excellent researcher and professor at UNLV. This book is aimed at showing consumers how they can improve their health and wellbeing in ways doctors really can’t help.  As regular readers of Cracking Health Costs know, medicine simply cannot deal with some our major risk factors. We address forty of those in this book, although a little irreverently at times.

Here is a synopsis written by our editor:

Health issues are an inescapable part of life—but by preparing for them, you can fend them off longer and handle them better when they do arise.

Offering eye-opening insight in a surprisingly lighthearted way, An Illustrated Guide to Personal Health teaches you how to manage your own health rather than depend on doctors and medicine—which often only narrowly addresses your overall well-being.

Skirting the typical fitness and dietary solutions, this guide provides forty common-sense practices you can incorporate into your regular routine to improve your resilience, reduce your stress, and ensure you will live healthier and happier for many years to come. With unexpected chapter titles like “Give Your Fork a Rest,” “Let Kids Play in the Dirt,” and “Don’t Take Multivitamins,” this self-help manual sets itself apart from the typical tips most health books offer, while still supporting its collection of timeless and innovative directives with citations from the medical field.

Health, wellness, and happiness go hand in hand—and only you can form the habits that will ensure you experience all three. Start learning how to improve your life today.

This blog accepts no advertisements, nor any paid “advertorials”, as do some blogs. We’ve published over 650 articles and have followers in Asia and Europe, as well as North America. Thank you for your comments, compliments, and especially criticism, the latter of which helps one become wiser.

Please consider supporting this blog by purchasing An Illustrated Guide to Personal HealthJust click here.

 

Tom Emerick

Tom’s latest book, “An Illustrated Guide to Personal Health” is now available on Amazon.

P.S. My first published book, Cracking Health Costs, co-authored with Al Lewis, was an Amazon trade best seller thanks in part to you support and was aimed at health and benefits professionals. Again the new book is for consumers.

 

 

 

Cancer drugs aren’t just really expensive; they’re a bad value

That stunning headline is from a Washington Post article. The author is Carolyn Johnson.

Writes Carolyn, “With some cancer drug prices soaring past $10,000 a month, doctors have begun to ask one nagging question: Do drug prices correctly reflect the value they bring to patients by extending or improving their lives?” The short answer is many cancer drugs do not.  That comment will not surprise regular readers of Cracking Health Costs.

Further, “ ‘Currently, the prices of cancer drugs are increasing, and the prices are not linked to the benefit that the drug provides,’ Daniel Goldstein, an oncologist at the Winship Cancer Institute at Emory University who led the study, said in an e-mail.”

Goldstein suggests, “We propose that drugs that provide a minimal benefit should have a low price, while drugs that provide a major benefit should have a high price.”

Makes sense in just about everything but drug pricing. Alas.

Tom Emerick

Tom’s latest book, “An Illustrated Guide to Personal Health” is now available on Amazon.

 

 

Show Wellness Isn’t an Epic Fail and Collect a $1-Million Reward

The title above is an offer made by my friend and coauthor of our book, Cracking Health Costs, Al Lewis.

As regular readers of this blog know, I’ve always been doubtful that company-sponsored wellness is effective in a way that does not produce a negative ROI. The recent Rand study should have ended the debate, but alas it did not, thanks to gross misinterpretation of the Rand results by articulate but misguided wellness vendors and other wellness true believers.

Al Lewis had thrown the gauntlet down in front of wellness advocates and vendors.

If you, your wellness vendor, or consultant wants to make a million dollars, just prove Al Lewis wrong.

See this link for the rules which in my view are quite reasonable.

 

Tom Emerick

Tom’s latest book, “An Illustrated Guide to Personal Health” is now available on Amazon.

 

 

iDoctor: wave of the future? Let’s hope.

“Medicine today is currently set up to be maximally imprecise” says Dr. Eric Topol. Regular readers of Crackinghealthcosts.com will understand that comment.

Topol, one of the world’s foremost cardiologists, has been a bit of a gadfly to big Pharma and the medical profession. He discusses a coming revolution in how personal health care will be delivered. There is a huge amount of talk these days about “telemedicine” and “digital” health care. Most of what I’ve seen hasn’t been very promising, frankly.

Topol describes something something called iDoctor, and other apps, that are as promising as anything I’ve seen so far.  See this youtube video for a full explanation.  Via iDoctor, huge numbers of tests can be done more cheaply and faster than how it works today, and could be much less wasteful in terms of patients’ time and convenience. (As we all know waste in US healthcare is prodigious.)

For example, the video shows an iPhone app that can instantly produce a cardiogram in a doctor’s office, thus “avoiding a $100 technician” fee and avoiding wasted time and inconvenience to the patient…all in one office visit. Let’s call that one-stop shopping.

Let’s hope doctors use this tool to save time, money, and patient aggravation.

 

Tom Emerick

Watch for Tom’s latest book coming to Amazon soon: An Illustrated Guide to Managing Your Health—HOW TO IMPROVE YOUR HEALTH IN 40 COMMON SENSE STEPS.

 

 

 

 

Simpson’s paradox and health care transparency

Simpson’s paradox occurs when data show the opposite of what is really true. That happens what there are “lurking variables” for which adjustments have not been made. Statisticians and experts in Six Sigma know this phenomenon well.

Health care “transparency” can lead to an abundance of Simpson’s paradoxes. The best surgeons may have low scores. The Health Care Blog, one of my favorites, has a story by SAURABH JHA, MD, illustrating how Simpson’s paradox occurs in comparing data on surgeons.

You can try to adjust for patient mix all you want but surgeon scorecards should be taken with a big grain of salt.

In my career, I’ve participated in a number of initiatives to provide healthcare transparency to consumers. They all fell short…Simpson’s paradox.

 

Tom Emerick

Watch for Tom’s latest book coming to Amazon soon: An Illustrated Guide to Managing Your Health—HOW TO IMPROVE YOUR HEALTH IN 40 COMMON SENSE STEPS.

Coffee—drink up

This is taken from The Doctor Weighs In post by Dov Michaeli.

Per the article, “Coffee drinkers have a reduced risk of dying prematurely from all causes, and consequently live longer.”  Coffee is a “vice” that is most worthy and one to be embraced.

Some health attributes of coffee include reduced risks of death from:

  • Cardiac arrhythmia
  • Type 2 diabetes
  • Dementia
  • Pneumonia
  • Lung disease
  • Accidents
  • Strokes
  • Etc, etc

That’s quite a list. The good news is that a 50 cent cup of coffee works as well as a five dollar cup. Any amount of coffee is better than none. According to results of a study by the NIH, “Compared with people who drank no coffee at all, men and women who drank six or more cups per day were 10% and 15% less likely, respectively, to die during the study.

Don’t tell wellness true believers about this. They may want to start charging coffee-free employees a higher health payroll deduction.

 

Tom Emerick

Watch for Tom’s latest book coming to Amazon soon: An Illustrated Guide to Managing Your Health—HOW TO IMPROVE YOUR HEALTH IN 40 COMMON SENSE STEPS.

 

Study casts doubt on breast cancer testing

The Guardian carried a story by Sarah Boseley about the controversy in Europe and other countries about the effectiveness and safety of mammograms. It seems some of the early studies on this were deeply flawed.

Per the article, “Internationally renowned cancer experts have cast fresh doubt on the benefits of breast cancer screening programmes, warning that they save fewer lives than previously thought.”

Says Professor Julietta Patnick, an expert on breast cancer, “…there are potential risks as well as benefits associated with breast screening, including over-diagnosis, and it is important that women are given information that is clear and accessible before they go for a mammogram.”

She calls for women to have truly informed consent so they can decide to have a mammogram or not.

This is a controversial area. Should employers be involved in promoting this and prostate screenings? I’m not so sure.

Tom Emerick

Watch for Tom’s latest book coming to Amazon soon: An Illustrated Guide to Managing Your Health—HOW TO IMPROVE YOUR HEALTH IN 40 COMMON SENSE STEPS.

Tips on evaluating a wellness program

This is news you can use.

If you want to evaluate the cost/benefit ratio of a wellness program, the following is a list of costs that are almost always overlooked in wellness evaluations. These are not the only things that need to be evaluated, just the ones most commonly overlooked.

When the items in the following list are fully considered, wellness evaluations can look entirely different.

  1. The cost of staff hired to manage the program. A rule of thumb is to multiply their salary times 2 to account for FICA, benefits, office space, training, workers comp, management, etc.
  2. The cost of wages for workers attending wellness events at work. One company I looked at was spending about $175 per employee per year on this, not a trivial sum.
  3. The opportunity cost of the HR staff running the program.
  4. The full cost of wellness communications. Sending wellness communications to people at work has a wage cost. See #2 above.
  5. The total cost to evaluate the program periodically.
  6. The cost of false positives caused by sending employees to doctors when they’re not sick. This is especially pernicious if you’re paying for wellness exams for employees. At one company the cost of the false positives, sometimes as high as $80,000 per event, nearly cost more than the physical exams themselves. You have to examine claims data to see this.
  7. If you have a fitness center, you need to take into account sports injuries for users. This involves access to claims data. I’ve evaluated the impact of fitness centers for three very large companies. Taking into account sports injuries, etc, your could not make the case for an ROI for any of the three of them. In one company, we examined claims data on a) moderate or occasional fitness center users, b) people who used the fitness center regularly, and c) non users.  Non users had the lowest average medical costs. Moderate users had higher medical costs than non users, and regulars users had the highest medical costs, a perfect reverse correlation.

Surveys of employees are notoriously unreliable. They measure employee opinions at best, but opinions are not facts. As we all know, sometimes in employee surveys people will say what they think the surveyor wants to hear.

Medical claims and sick pay data are about the most meaningful ways to measure wellness outcomes. Short and long term disability data can be useful too, as can life claims experience when compared to norms. If you only use employee surveys/HRAs and other surrogate data, too bad.

I met an actuary who spoke at a conference on this topic and used the measurements above to evaluate wellness programs. He said he’d never seen one that had a positive ROI, except ones that used payroll deduction penalties.

Tom Emerick

Watch for Tom’s latest book coming to Amazon soon: An Illustrated Guide to Managing Your Health—HOW TO IMPROVE YOUR HEALTH IN 40 COMMON SENSE STEPS.

Victims line up for cancer doctor’s sentencing

The Detroit News carried a story by Laura Berman about the sentencing of a rogue doctor named Farid Fata, who diagnosed patients with cancer when, in fact, they did not have cancer. He gave them massive doses of chemotherapy which killed many of them. It seems there were about 550 victims…all for profit.

He was a kindly looking person. He probably had a good beside manner, too, and may have been well-liked by his victims. But he was a medical monster.

Writes Berman, “Fata has been compared by government lawyers to financial fraudster Bernard Madoff for the brazen scope of his crimes and his willingness to prey on those who trusted him. At least two expert medical witnesses for the government are scheduled to testify during the sentencing hearing.”  That is a bit of an unfair comparison as Madoff was stealing money, but not killing people.

But like Madoff, some people in Fata’s office had to know what was going on. Why aren’t they going to jail too?

When benefit managers and their consultants demand networks with the most providers, this is one result.

 

Tom Emerick

Watch for Tom’s latest book coming to Amazon soon: An Illustrated Guide to Managing Your Health—HOW TO IMPROVE YOUR HEALTH IN 40 COMMON SENSE STEPS.