What Does Google Health's Failure Have To Do With Watergate ?

I like good movies for a lot of reasons but often for the memorable quotes you get from time to time. I enjoy sharing a line from an iconic film at a cocktail party when referencing the latest topic Du jour. In All The President's Men, Deep Throat, the government informant who spoke in riddles and metaphors in response to Woodward and Bernstein's questions recounted, "follow the money". Following the money is often good advice and is one of those quotes that I love to use. It explains a lot of things.

So what does Google's recent announcement that it is discontinuing Google Health have to do with Watergate ? Just "Follow The Money".

I a March 2011 post "Where Is Google Health In The Evolution Of Wellness ?" I talked about the promise of technology in evolving health care and fitness into wellness. Interestingly I received a number of communications following the post from people who seemed to know Google Health was being shuttered. But why would this promising idea get the shaft ? In a recent Technology Review article , How A Broken Medical System Killed Google Health , correspondent David Talbot wrote:

At the end of this year, Google Health will flat line. The service couldn't encourage many people to import or analyze their health data, and experts say its untimely death is, in many ways, an extension of U.S. health-care providers' failure to share data across institutions, or make it easy for patients to obtain it.

David's tag line to the article said it best, "Google would have had to fix a balkanized U.S. health-care system to make the service catch on." He's right and I know it first hand.

I recall my treatment for colon cancer and repeated and unsuccessful attempts to get my group of five physicians to utilize Google Health. Despite Quest Diagnostics providing access to my diagnostic records electronically for free on Google Health, not one my physicians knew about it or cared to use it. Instead I would have to suffer duplicate tests, hauling records around and harassing people to fax results. Even more interesting was a strategic session with leaders in the Medical Fitness field. Not one of the participants knew what Google Health was. Amazing but why ? Why would a system that offered real solutions to a broken system be so unfamiliar to so many ? Follow the Money.

The failing of and lack of awareness of solutions like Google Health in either the "Sick Care" system or the "Wellness" prevention system highlights the obvious: there is NO money in improving health outcomes. As Bryce William's recent article in Fast Company "There Is No Such Thing As A Health Care Consumer" points out about the failure of Google Health:

...the underlying cause is that there is no such thing as a consumer in the American health care system today. A consumer is someone who uses personal dollars to buy goods and services for his or her own use. In our health care system, the users of medical services are, of course, individuals. But users don’t pay the largest share of costs for these services. Employers, the government, and health insurance companies do. So while people may be highly concerned about quality medical care, most are not motivated to manage costs.
 With that fundamental understanding, it’s easy to see why Google Health failed.

And that is the problem, its up to consumers, who have no real incentive to improve their health, and its up to delivery systems that have no incentive to deliver it. So when I ask What does Google Health's Failure Have To Do With Watergate, you might just "follow the money".

So tell me, Bryan O'Rourke, why do you think Google Health failed ? Why has the U.S. and world's populations become less healthy while the cost of care sky-rockets amid a push for healthier lifestyles by the fitness industry. Is it a broken system ?

Private Insurance, Health Care & Corruption

Opening the NY Times this morning I read of record profits reported by the U.S. insurance industry in 2009. The nation's five largest for-profit insurers had a combined profit of $12.2 billion, according to a report by the advocacy group Health Care for American and overall the companies increased their profits by 56 percent in 2009, a year that saw 2.7 million people lose their private coverage.

As a student of economics I appreciate capitalism - but this is no free market scenario. I also understand the theory of insurance as  what it is supposed to be: a form of risk management used to hedge against the risk of a contingent loss. An equitable transfer of the risk of a loss, from one entity (the person) to another (the insurance company), in exchange for a premium. But in health care, from a public good standpoint, can we really continue to allow private companies to take the cream off the top of our imploding health care system ? What is the fear of the public option ? Its about money and corruption.

The insurance companies continue to drive profits up amid rising costs by paying out less and less in claims while charging more for premiums. This is irrefutable. As the PriceWaterhouseCoopers Health Research Report showed, payments for claims as a percentage of premiums have dropped significantly in the past 14 years, while Medicare outlays have stayed at 97% (see graph below).

The true reason the "public option" is so unpopular among some folks , particularly congressional types, is that when a publc option comes to the marketplace the price will be so much more competitive as to render the for profit insurance companies useless.  Its called competition. If one follows the money in the world of Congress, both for democrats and republicans, there is a high correlation between their views and contributions by the existing profiteers of our health care system - the insurance companies among others. Carl Bernstein recently lamented that the debate over and the writing of health care reform legislation has shown us "Congress at its worst."

The concept of author, professor and activist Larence Lessig "Good Soul Corruption" is a good idea to get your head around if you question why, given the huge profits of private insurance companies, many oppose a public option as some form of evil.

Watch the video below and learn how profit interests effect public policy.


How Health Care Kills People

My Dad, William R. O'Rourke, Jr., passed away on Sunday, December 27, 2009; a day after his 72nd birthday (details here for friends and family). He suffered from CLL, a form of leukemia and had a tough battle during his final days. Dad was a terrific man. He had a distinguished career as a highly dedicated Air Force officer and pilot. He was a consultant to, ironically, the health care industry and served as a contract executive for a number of firms. He was a professor and intellectual while being a very down to earth and personable man and I loved him very much. Thanks for everything Dad - you will be missed.

We all have or had fathers and many of us are lucky enough to have received their support and love during our lives. Given this, what is painful to see first hand is the nature of the health care system they enter into when they are very ill. My experience personally during the past year is wrought with evidence of a dysfunctional system. When people get really sick, its broken nature becomes all the more apparent. This is not meant as an affront to the many professionals who attempted to provide care, nor is it about being able to afford care because Dad thankfully had the means. My sentiments are based on witnessing a SYSTEM that fails to provide quality because it is based on flawed economics.

If you haven't read David Goldhill's New Yorker article, How American Health Care Killed My Father, you must. See some of his views above in the video. While my Dad was ill, I can promise you the quality of his life and his experience of care was woeful and would have been much better if the system were changed fundamentally. David's testimony above reflects many of the same things I experienced.  As a business executive like me, David began a personal exploration of a health-care industry that for years has delivered poor service and irregular quality at astonishingly high cost. It is a system that is not worth preserving in anything like its current form. And the health-care reform now being contemplated will not fix it. He has a radical solution to this agonizing problem.

X-Prize: A Solution for Health Care

X-Prize recently announced they are extending their model to healthcare with a $10 million prize, intended to "catalyze dramatic improvements in health and health care value in the United States." Read the full release here. "if you can't measure it you can't change it" says the X-Prize CEO Dr.Peter Diamandis in the video below. What's the measure in health care ? That is problem in the extant health care model. The highest quality care at the best cost still entails a scarcity paradigm: at some point extending care to an individuals does not generate an ROI for the overall system. Who is going to make those choices ? The X-Prize outcome will be interesting because the solution is complicated; until consumers have an understanding on par with the system that delivers their care and until individuals are rewarded or penalized for behaviors that contribute to outcomes, the idea of "choice" is an oversimplifed solution to this complex problem.

Peter Diamandis, CEO, X-Prize Foundation from Health 2.0 on Vimeo.