Tag: Kim Bellard

A New Kind of Labor Day

Sep 8, 2020

By KIM BELLARD

This is probably the strangest Labor Day in decades, perhaps ever. Tens of millions of workers remain unemployed due to the COVID-19 pandemic. Many of those who are still working are adapting to working from home. Those who are back at their workplace, or never left, are coping with an array of new safety protocols.

Those who work in the right industries – like the NBA – may get tested regularly but most workers have to figure out for themselves when to quarantine and when to get tested. For many workers, such as health care workers, people of color, and workers with underlying health issues, going to work is literally a life-or-death calculation.

No wonder that experts, like Dr. David B. Agus, are calling for companies to have Chief Health Officers.

Labor Day was originally intended to celebrate the labor movement, but these days labor unions don’t have much to celebrate. Only around 10% of U.S. workers belong to a labor union; both the number and the percent of unionized workers has been in steady decline over the past few decades.

Now Labor Day is mainly an extra day off for most, the unofficial end to summer, and, this year, possibly the springboard to a new surge in COVID-19 cases, due to holiday celebrations. Dr. Anthony Fauci warned:

The Wrong Legacies

Sep 3, 2020

By KIM BELLARD

I read two articles this week that got me thinking, Robert Charette’s “Inside the Hidden World of Legacy IT Systems” (IEEE Spectrum) and Douglas Holt’s “Cultural Innovation” (Harvard Business Review). Both deal with what I’ll call legacy thinking.

It’s a particular problem for healthcare.

———-

If you work in a large organization, especially one that has been around for at least a few decades, the words “legacy system” probably strikes angst in you. If you’ve dealt with such an organization, legacy systems probably contributed to problems you may have had with them. Think about health insurance claims systems, hospital billing systems, financial institution account records, or practically any government system.

Dr. Charette points out:

Though these systems run practically every aspect of our lives, we don’t give them a second thought because, for the most part, they function. It doesn’t even occur to us that IT is something that needs constant attention to be kept in working order.”

Because they usually work OK, management often doesn’t want to risk the potential disruption of replacing or modernizing them, so they get older and older, with more and more layers built on them, and with the people who originally built them or understand the language they are written in (e.g. COBOL) gone.

Thriving in COVID Times

Aug 25, 2020

By KIM BELLARD

These are, no question, hard times, due to the COVID-19 pandemic. In the U.S., we’re closing in on 180,000 deaths in the U.S. Some 40 million workers lost their jobs, and over 30 million are still receiving unemployment benefits. Hundreds of thousands, if not millions, of small businesses are believed to have closed, and many big companies are declaring bankruptcy. Malls, retailers, and restaurants have been among the hardest hit.

Yes, these are hard times. But not for everyone.

Last week Target announced what CNBC called a “monster quarter.” Sales for online and stores open at least a year jumped 24% for the quarter ending August 1 – peak COVID-19 days – and profits were up an astonishing 80%. Its CEO specifically referenced the pandemic, as shoppers sought safe and convenient shopping options.

It is not just Target doing well. No one should be surprised that Amazon is doing well, as more turn to online shopping and Amazon’s quick delivery, but The Wall Street Journal reports that Bog Box stores generally are doing well, including not just Target but also Walmart, Home Depot, Lowe’s, Costco, and Best Buy. The efforts they were taking to compete with Amazon, such as increased online sales and curbside pickup, served to help them survive the pandemic’s effects.

Similarly, if you’re a streaming service like Netflix or Disney+, the pandemic has been great for business. Video conferencing services like Zoom are booming. Car dealers are struggling, but not online car sales.

And, of course, if you’re a cloud computing service supporting all these shifts to online, the world has become even more dependent on you. “Many customers are scaling beyond their wildest projections,” Carrie Thorp of Google Cloud told WSJ.

THCB Gang Episode 22, 8/20

Aug 20, 2020

Episode 22 of “The THCB Gang” was live-streamed on Thursday, August 20th! Watch it below.

Joining Matthew Holt (@boltyboy) today are some of our regulars: writer Kim Bellard (@kimbbellard), patient safety expert Michael Millenson (MLMillenson), MD & hospital system exec Rajesh Aggarwal (@docaggarwal), data privacy expert Deven McGraw (@healthprivacy), and Casey Quinlan (@MightyCasey). The conversation revolved around the responsibilities of the CDC & HHS, why the data hasn’t been shared properly around COVID19 transmission, and why payers & providers are cautiously innovating health care.

If you’d rather listen to the episode, the audio is preserved as a weekly podcast available on our iTunes & Spotify channels — Zoya Khan

An Epic Fight for the Metaverse

Aug 19, 2020

By KIM BELLARD

You might have missed it amongst all the headlines about the U.S.P.S., the 2020 elections, and, of course, that little thing we call the pandemic, but Fortnite got kicked off Apple’s App Store (and subsequently Google Play).

I’m not a gamer, but I am fascinated by gaming, because, as Steven Johnson put it, “The Future is where people are having the most fun.” Tim Sweeney, the founder and CEO of Epic Games, Inc., which makes Fortnite, seems to be having a lot of fun. And he thinks the future is the Metaverse.

Healthcare, take note.

The tech giants were reacting to Epic allowing “permanent discounts” on developer fees for in-game purchases made directly, rather than going through Apple or Google. Developers thus avoid the 30% commission charged in those Stores. Mr. Sweeney has been railing about the commission level for some time, leading to the recent decision.

Apple tried to justify its action:

Today, Epic Games took the unfortunate step of violating the App Store guidelines that are applied equally to every developer and designed to keep the store safe for our users. As a result their Fortnite app has been removed from the store. Epic enabled a feature in its app which was not reviewed or approved by Apple, and they did so with the express intent of violating the App Store guidelines regarding in-app payments that apply to every developer who sells digital goods or services.

Take Your Mom to Work

Aug 12, 2020• 1

By KIM BELLARD

If you are a working mom, or married to one, or simply know one, you know that it is tough to balance a job and raising a child even under ideal circumstances. Even if she has a supportive spouse, chances are that it is the mom who ends up providing the most child care, and whose career it impacts the most.

But, of course, these are not ideal circumstances. Prior to the pandemic, women had made great strides in the workforce; more women had payroll jobs than men, for example (although they continued to be paid less for them). Those gains quickly came crashing down once the pandemic hit. It is believed to be the first time that job and incomes losses have hit women harder than men. Some are calling our pandemic-driven economic downturn a “shecession” as a result.

That’s bad enough, but the even bigger danger is that the pandemic could set back women’s careers for a generation.

A recent study by Collins, et. alia confirmed what most might have guessed: in the wake of the pandemic, women are more likely than men to have reduced their work hours to take on additional child care responsibilities due to school/daycare closing — four or five times as much.

The study found that:

Scaling back work is part of a downward spiral that often leads to labor force exits—especially in cases where employers are inflexible with schedules or penalize employees unable to meet work expectations in the face of growing care demands.

We are also concerned that many employers will be looking for ways to save money and it may be at the expense of mothers who have already weakened their labor market attachment.

Even more worrying, lead author Caitlyn Collins, a professor at Washington University, says: “Our findings indicate mothers are bearing the brunt of the pandemic and may face long-term employment penalties as a consequence.”

Health Insurance Needs to Grow Up

Aug 3, 2020• 1

By KIM BELLARD

I’ve been covered by private insurance my entire life. Even more telling, I worked in the health insurance industry for — gasp! — some thirty years. It’s not just paid for my healthcare, it’s financed my life.

Today, though, for the first time in my life, I’m covered by public insurance — and I couldn’t be more relieved.

Now, I’m not going to go all Wendell Potter. I know many people have their health insurance horror stories, but, sadly, people have them about pretty much every part of the healthcare industry. I believe most people working in health insurance, like most people working in healthcare generally, sympathize with the people they serve and are just trying to do a good job.

The problem is that the health insurance model has outgrown the times. I’ll try to explain some ways how.

Premiums

Once upon a time, most people had employer coverage, and those employers paid all or most of its cost. Those days are gone. Employer coverage is still the predominant form of private health insurance, and employers still pay the majority of its cost, but percentage of people with employer coverage continues to drop and the amount they pay for it continues to increase.

THCB GANG, Episode 20

Jul 30, 2020

Episode 20 of “The THCB Gang” was live-streamed on Thursday, July 30th! Watch it below!

Joining Matthew Holt were some of our regulars: writer Kim Bellard (@kimbbellard), MD & hospital system exec Rajesh Aggarwal (@docaggarwal), health futurist Ian Morrison (@seccurve), WTF Health Host Jessica DaMassa (@jessdamassa), and guest Jennifer Benz, communications leader at Segal Benz (@jenbenz). We discussed how employers & health plans need to build trust in order to improve engagement data, how health consumers’ are changing the way they interact with health care, and how to support patients when they are accessing the system.

If you’d rather listen, the audio is preserved as a weekly podcast available on our iTunes & Spotify channels — Zoya Khan

Too Many Small Steps, Not Enough Leaps

Jul 28, 2020

By KIM BELLARD

I was driving home the other day, noticed all the above-ground telephone/power lines, and thought to myself: this is not the 21st century I thought I’d be living in.

When I was growing up, the 21st century was the distant future, the stuff of science fiction. We’d have flying cars, personal robots, interstellar travel, artificial food, and, of course, tricorders. There’d be computers, although not PCs. Still, we’d have been baffled by smartphones, GPS, or the Internet. We’d have been even more flummoxed by women in the workforce or #BlackLivesMatter.

We’re living in the future, but we’re also hanging on to the past, and that applies especially to healthcare. We all poke fun at the persistence of the fax, but I’d also point out that currently our best advice for dealing with the COVID-19 pandemic is pretty much what it was for the 1918 Spanish Flu pandemic: masks and distancing (and we’re facing similar resistance). One would have hoped the 21st century would have found us better equipped.

So I was heartened to read an op-ed in The Washington Post by ReginaDugan, PhD. Dr. Dugan calls for a “Health Age,” akin to how Sputnik set off the Space Age. The pandemic, she says, “is the kind of event that alters the course of history so much that we measure time by it: before the pandemic — and after.”

Healthcare Should Get Into Some #GoodTrouble

Jul 21, 2020• 1

By KIM BELLARD

As hopefully most of you know, Rep. John Lewis, civil right icon and longtime member of Congress, died this past Friday. Rep. Lewis was often described the “conscience of Congress” – perhaps a low bar in today’s Congress but important nonetheless — for his unwavering commitment to social justice. I have always been struck in particular by one of his quotes:

Rep. Lewis must have been heartened by the fact that, in 2020, plenty of people are, indeed, making noise and getting into good trouble, necessary trouble over issues that he cared deeply about, like Black Lives Matter and voting rights. There are others who are better able to write about those people and that trouble. So I’d like to talk about his call to action with respect to healthcare.

If you are working today in healthcare — especially in the United States — or, for that matter, someone getting healthcare or having a loved one get it, then you should be making some noise and getting into good trouble, because our healthcare system most definitely makes it necessary.

It should come as no surprise that we’re not very happy with our healthcare system, rating it lower than do citizens in most other developed countries. And for good reason: it’s the world’s most expensive while delivering sub-par health results and leaving tens of millions without financial protection. Even our physicians don’t like it. Even our latest, best effort for improving the sorry state of our healthcare system — the Affordable Care Act – is under risk of repeal due to a lawsuit brought by 18 states and backed by the Trump Administration.

Every day, too many of us suffer in the healthcare system, ranging from waits to indignities to critical mistakes, and some face financial ruin due to the care — whether good or bad. Most of us suffer in silence, or only complain to our friends and family. We don’t see a lot of mass protests about the pitiful state of our healthcare system, and I have to wonder why.

We have to stop being so passive.