Notes & Links: October 9, 2013

Deadly Disbelief
Kent Sepkowitz writing in Slate helps us revisit AIDS and HIV that many of us may have forgotten. Not what causes it and that it is deadly or that it is being effectively managed thanks to the hard work of the pharmaceutical industry being beaten senseless by AIDS activists before they realized market value. What Sepkowitz gets us to think about are the AIDS denialists who are still there. And the harm they do though is not half as damaging as the anti-vacination foilhat wearing crew.

This is a good read and one we need to perform annually.

Health Insurance Premiums in the Exchanges Pt. 1
Tim writing on Tim’s Stuff just published this post. Got to say what’s there not to love about a self-described boring Mormon economics grad student who is into insurance and health policy. And not to leave out cycling my fav. 

His post Part 1 is rather enlightening just because it speaks not in screaming advocacy or exploding hate about the ACA or ObamaCare depending on where you reside on your ‘I know more than you do scale’ but in quite calm fact based logic. 

There are two reasons why an individual’s insurance premiums might be rising this year. First, your plan may be changing. More likely than not, your plan is becoming more comprehensive. This is to comply with new regulations requiring plans to have an actuarial value greater than or equal to 60%. A plan’s actuarial value is the portion of health care costs the plan will cover for an average individual. Most individual plans currently fall short of the 60% requirement, so people currently holding individual policies will probably see their plans change to qualify, raising the price.1 This price increase does not come without corresponding benefits, however. Not many people are complaining about having to purchase more comprehensive coverage which they probably couldn’t get last year.

Second, new regulations require health insurance premiums to be “community rated.” No, this does not mean that everyone in your community has to go somewhere and rate every health plan. It means that plans can’t charge different people different premiums for the same plan. Now, the law does not require perfect community rating. Instead, it allows health plans to vary premiums by age, geography, and smoking status. Really, it just prohibits charging different premiums based on health status, i.e. a health plan can’t charge a sick person more than a healthy person for coverage via the same health plan.

he above is pretty much it for Part 1 but it opened my eyes. Tim has a bunch more on his site on insurance and health policy. Good reading someone’s got to write this stuff and make it accessible. 

40 Maps That Will Help You Make Sense of the World
This link is from Doc Searls Weblog and is brilliant, let me say that again BRILLIANT. One just for the content and execution of these maps but, the fact anyone doing a PowerPoint deck always needs a map. Well here ya go you will find a map just right to make your point dramatic and clear.

Just check this out. Boom that was my mind blowing up. And it is not only maps this site is sick.  

Notes & Links: August 29, 2013

Curated Social Media Resources About Disability
Webicina has curated an excellent collection of disability focused blogs, podcasts, slideshows, mobil application and community sites. Another fine resource from this site. Spead the word.

The Most Effective Obamacare Delay is Defunding
Chris Jacobs writing in The Health Care Blog reiterates the current scream from the right; defund Obamacare. He makes the argument that real conservatives don’t want to shut down government to destroy Obamacare. It reads like this:

We should not buy into the false assumption that efforts to defund Obamacare equate to a shutdown of the federal government. Heritage and others have pushed for Congress to fully fund regular government operations and separate Obamacare from annual appropriations. But conservatives of either party in Congress have no leverage on any of these critical issues unless the President believes that he will have to assume the responsibility of a government shutdown.

It is an interesting argument but more to my posting this are the comments. Comments alone are worth the price of reading this standard conservative blah blah about making sure only the few have healthcare. The comments are rich with pro and con and a smattering of wing-nuts.

EveryMove Launches the EveryMove 100 Health Insurance Index
Russell Benaroya writing on The Health Care Blog introduces a newly minted list of health insurance companies focused on engaging consumers to help them take control of their health as a partner. The index evaluates the following categories:

Social media presence and interactions (breadth and depth of engagement)
Mobile investments (mobile web and app ecosystem)
Website statistics (popularity ranking, refreshed content)
Customer support access (availability/ease of access)
Current consumer satisfaction (what are current members saying)

Beyond the fact this is a great index and it helps consumers find new measures to use when selecting health insurance Benaroya speaks to the strategic need of insurers to engage patients better through new media, mobile, and just plain customer service. The index can be found here.

Using Twitter to Examine Smoking Behavior and Perceptions of Emerging Tobacco Products
Myslin, Zhu, et. al. publishing in JMIR offer what is the future of using Twitter to perform effective and highly relevant “infoveillance”. We all know what Twitter is and how it works. Many of us know that Twitter is being used by the CDC regarding influenza informedness as a health status surveillance methodology. We also know Twitter has uncovered poor public informedness and misuse of antibiotic. But this for this study Twitter is used to:

  • perform content analysis of tobacco-related tweets
  • improve signal to noise ration in Twitter by automatically filtering out irrelevant content 
  • demonstrate the utility of Twitter in addressing new public health challenges re: tobacco 


The authors with their very complete and carefully designed study have been able to identify opportunities for tobacco education.

The next most common genre, marketing, is followed relatively distantly by information and news, and most tweets in these categories are not posted by recognized health or news organizations. In sum, reliable information is far less accessible on Twitter than are opinions, marketing posts, and information from unverified sources, indicating potential for greater public education in tobacco prevention policies.

Think about the above and how Twitter is void of EBM references to tobacco use and it’s outcome. 

In this regard, Twitter surveillance may reveal insights not available through surveys, where participants do not spontaneously relate experiences to an audience of friends and followers and are instead more likely to express more carefully crafted opinions. Indeed, surveys may thus underestimate the prevalence of positive sentiment toward tobacco.

And Twitter allows us see deep inside the person, their motivations, reactions, and driving forces. Very important if we are to engage people in their healthcare beyond tobacco. Let’s say we do this same analysis on hypertension and behavior. 

The authors are quick to identify the fact they only used 1% of Twitter feed and their annotated dataset was small as was their number of smoking keywords. But all in all this is a fantastic look at the potential of Twitter to uncover and point out direction for education and engagement. 

July 3, 2013 Interesting Reads

NEJMEnvy- Strategy for Reform England vs. US in healthcare. The focus ” on the most positive aspects of each system, the characteristics that should inspire envy, we may find solutions to each country’s challenges just an ocean away.” 

This article covers some key areas that we should consider if we are going to improve our healthcare system. Well worth the read.

Incidental EconomistOn What Do Health Economists Agree? This is an interesting concept looking at ‘positive (as opposed to normative) statements’ Here are a few the post is open to suggestions and comments. 

  • Health insurance does not guarantee good health care.
  • Preventive care does not usually pay for itself.
  • Employees pay for all employer-based health benefits; they offset wages or other benefits.
  • Favorable tax treatment of employer-based health benefits leads to greater employer offers and more generous benefits.
  • Employer-based plans serve a risk pooling function.
  • Cost sharing reduces utilization.
  • Physicians influence patients’ level of utilization.

Webfonts by H&FJ: Introducing Cloud Typography

Great idea. It is a cloud technology for type where typography answers each browser with the right type and fast. I wonder if us mere mortals will notice the difference?