[Vision2020] Vision2020 Digest, Vol 67, Issue 249

Katherine Sprague kathys at moscow.com
Wed Jan 18 14:10:47 PST 2012


----- Original Message ----- 
From: <vision2020-request at moscow.com>
To: <vision2020 at moscow.com>
Sent: Wednesday, January 18, 2012 12:45 PM
Subject: Vision2020 Digest, Vol 67, Issue 249


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> Today's Topics:
>
>   1. Re: More Proof Preventative Health Care Saves (Jay Borden)
>   2. Re: More Proof Preventative Health Care Saves (keely emerinemix)
>
>
> ----------------------------------------------------------------------
>
> Message: 1
> Date: Wed, 18 Jan 2012 12:51:32 -0800
> From: "Jay Borden" <jborden at datawedge.com>
> To: "Tom Hansen" <thansen at moscow.com>
> Cc: vision2020 at moscow.com
> Subject: Re: [Vision2020] More Proof Preventative Health Care Saves
> Message-ID:
> <AF80DB24B7E90143B959A2225AD3FEA675933D at sol.DataWedge.local>
> Content-Type: text/plain; charset="utf-8"
>
> My heart goes out to the folks behind the examples you cite during your 
> (hopefully brief) stay in the ICU? but they have nothing to do with human 
> nature and prevention.    Your examples strike towards insurance and 
> coverage? not preventative medicine.
>
>
>
> The most recent personal example I have doesn?t deal with health care, so 
> I?m sure it will be attacked as irrelevant? but it certainly strikes at 
> human behavior.   (If you consider it too irrelevant, then chalk it up to 
> ?personal analogy?).
>
>
>
> My second company (a widget producer) is the result of my taking over a 
> bankrupt enterprise nearly two years ago.  The previous owner was 
> severally in debt, was in the process of declaring personal bankruptcy, 
> and was in the process of just walking away from the entire business.
>
>
>
> Without diving too far into detail about the business, I found that the 
> company was in financial ruin because of the sheer number of returns of 
> widget sub-components.  An excel spreadsheet told me that there was over a 
> 200% return rate for the widgets? (for every widget sold, a customer (on 
> average) would return it for an exchange/replacement at least twice).
>
>
>
> As the number of exchanges grew, the previous owner (fearing customer 
> backlash at product quality) would increase the length of the warranty, 
> and try to off-set the replacement cost by raising the price of the 
> widget.
>
>
>
> Lengthening the warranty period only made the problem worse? customers had 
> a larger window to return the widgets for replacement.
>
>
>
> Turns out the problem had nothing to do with design? it was customers not 
> bothering to read or learn anything about proper use of the widgets, or 
> trying to use the widgets for a completely different purpose altogether.
>
>
>
> Tack on a free replacement guarantee, and customers didn?t bother to 
> self-educate? they just let the company ?fix the problem? with the 
> warranty.
>
>
>
> The first thing I did was change the warranty policy? and I shortened to a 
> VERY SHORT length of time (to allow for ?out of the box? failures).  I 
> followed this up with a dramatic reduction in price, making ?true? 
> failures after a length of time affordable to replace.
>
>
>
> The problem went away overnight.  Immediately customers started 
> calling/emailing?  wanting to know more about proper installation 
> procedures, proper use of their product, and ?whether it would work in 
> misc. environment X?.
>
>
>
> As soon as it became the customer?s responsibility to take care of the 
> widget, it suddenly had increased value to them, and they were more 
> careful with it and made sure they used the widget properly.
>
>
>
> The difference between the has been one of business SUCCESS vs. business 
> FAILURE.
>
>
>
> The (new) company has survived? customers have a parts solution? and life 
> has continued.
>
>
>
> Yes, I realize that many of you will probably dismiss this as irrelevant, 
> since it doesn?t contain ?health care?? but it?s human nature.  People 
> tend not to care about something when someone else foots the bill.
>
>
>
> Whether you?re talking about widgets or high-blood pressure? if someone 
> else is footing the bill and responsibility, people will generally tend to 
> not think about the consequences or the price tag, and just go with 
> whatever is easy.
>
>
>
>
>
> Jay
>
>
>
>
>
>
>
>
>
> From: Tom Hansen [mailto:thansen at moscow.com]
> Sent: Wednesday, January 18, 2012 11:56 AM
> To: Jay Borden
> Cc: Donovan Arnold; <vision2020 at moscow.com>
> Subject: Re: [Vision2020] More Proof Preventative Health Care Saves
>
>
>
> Jay Borden stated:
>
>
>
> "I can tell you first-hand my experiences on how human behavior changes as 
> soon as fiscal responsibility to pay is shifted to the individual as 
> opposed to a faceless 3rd party."
>
>
>
>
>
> Care to share some of your "first-hand experiences", Mr. Borden?
>
>
>
>
>
> Or perhaps I should share some of mine . . . after spending 30+ days in 
> the waiting room of Sacred Heart Medical Center's ICU (12/15/2011 - 
> 1/17/2012), like . . .
>
>
>
>
>
> . . . the one I mentioned earlier concerning the patient, whose activity 
> on the left side of his brain was ever so slowly recovering, and his 
> mother who was extremely concerned about how her son's medical care was 
> going to be financed . . . two months after he was laid off, and
>
>
>
>
>
> . . . the family who, while their father lay terminally ill not fifty feet 
> down the ICU hallway, were openly discussing who was going to contribute 
> how much to pay their father's medical bills, after having already cashed 
> in his life insurance, and . . .
>
>
>
>
>
> . . . remember that fatal accident that happened about two miles outside 
> of Reardan, Washington (reported in the Spokesman-Review) on New Year's 
> Eve.  The critically injured were transported to SHMC ER and in to ICU. 
> Talk about a reality wake-up call . . .
>
>
>
>
>
> Care to share yours with us, Mr. Borden?
>
>
>
>
>
> Seeya later, Moscow.
>
>
>
> Tom Hansen
>
> Post Falls, Idaho
>
>
>
> "If not us, who?
>
> If not now, when?"
>
>
>
> - Unknown
>
>
> On Jan 18, 2012, at 11:35 AM, "Jay Borden" <jborden at datawedge.com> wrote:
>
> I can tell you first-hand my experiences on how human behavior changes as 
> soon as fiscal responsibility to pay is shifted to the individual as 
> opposed to a faceless 3rd party.
>
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> Message: 2
> Date: Wed, 18 Jan 2012 12:45:41 -0800
> From: keely emerinemix <kjajmix1 at msn.com>
> To: <jborden at datawedge.com>, <donovanjarnold2005 at yahoo.com>,
> <vision2020 at moscow.com>
> Subject: Re: [Vision2020] More Proof Preventative Health Care Saves
> Message-ID: <COL105-W25A82FA02ACE754F52442582810 at phx.gbl>
> Content-Type: text/plain; charset="windows-1252"
>
>
> I think, Jay, we have all seen a multitude of examples of "people making 
> BAD decisions" in the healthcare climate we endure these days in the U.S. 
> Most of the time, those decisions are made by insurers, whose approach to 
> market-driven, business-model healthcare counts every single cost except 
> for the very real personal costs inflicted on sick people.
>
> I don't see the truth in your example that using "other people's money" in 
> healthcare distribution is like you and me going to a restaurant and my 
> ordering not the lobster I would've if I'd known you were paying and, 
> lacking that knowledge, ordering only the soup-and-sandwich combo.  Bad 
> manners in social interactions are not the same thing as denying people 
> access to preventative care that not only spends healthcare dollars wisely 
> in prevention and early diagnosis, with better treatment outcomes, as well 
> as empowers people to manage their own personal health.  You seem to 
> believe that the indignation I might feel that someone "orders up" if I'm 
> paying is at all analogous to having access to and making use of 
> comprehensive preventative, diagnostic, and treatment options that by 
> every standard improves the life -- and life expectancy -- of the patient. 
> It isn't.
>
> I cannot imagine a scenario under which people "pig out" by availing 
> themselves of "other people's money" -- which, given the tax-supported 
> nature of government involvement in healthcare is actually THEIR own 
> money -- to pay for their scooping up each and every test possible. 
> You're aware, I know, that most diagnostic tests are ordered by doctors 
> themselves, not by patients.  In other words, while I might call and 
> schedule my own mammogram (at my doctor's recommendation), I can't just 
> wake up one morning and decide that an MRI would be a fun way to pass the 
> day.  No, those tests are ordered by physicians.  I suspect you haven't 
> had the experience of having your doctor suggest that you have an MRI to 
> pinpoint the source of your pain, or a complete blood panel to rule out 
> leukemia, only to have to tell her/him that you can't afford it -- either 
> because you're uninsured, or because you carry a $10,000 family deductible 
> and can't come up with your share of the cost.  Further, i!
> t's hard for me to imagine that you actually envision a world in which 
> "too much" medical care is a bad thing, unless, of course, you're in the 
> camp that believes that Grandma really ought to have to have her case 
> reviewed by managers disinclined to spend money on an 80-year-old.  If 
> you're at all "pro-life," you're not.  But you tell me.
>
> Finally, I think that you and I would measure the moral strength of a 
> country in different ways.  You seem to think that the market-driven, 
> frankly discriminatory stinginess now evident in the way this nation deals 
> with healthcare is not only a good business model, but an honorable way to 
> have its citizens deal with each other -- and not as equals or as 
> co-citizens, but in a hierarchical model that ensures that those in power, 
> those who are not doctors, those who control the pursestrings and thus 
> make life-and-death decisions that result in death, not life, are entitled 
> to inflict a business model on people who are only "customers," disposable 
> and easily forgotten.  I disagree.  The measure of this nation's moral 
> character is when the gap between the have's and the have-not's, while 
> evident in other areas, should never result in the acceptability of early 
> death and prolonged suffering because it makes business sense to people 
> whose healthcare needs are immune to the "silent !
> hand of the market."  That, I'd never apologize for.  I'm just amazed that 
> you and others would defend it.
>
> Keely
> www.keely-prevailingwinds.com
>
>
> Date: Wed, 18 Jan 2012 11:35:41 -0800
> From: jborden at datawedge.com
> To: donovanjarnold2005 at yahoo.com; vision2020 at moscow.com
> Subject: Re: [Vision2020] More Proof Preventative Health Care Saves
>
>
>
> It sounds great? the math might be right, but I believe the human nature 
> component is wrong? human nature changes when dealing with ?other people?s 
> money?.   (?Oh, if I had known you were paying for dinner, I would have 
> ordered something more expensive??) Putting the word ?preventative? in the 
> name doesn?t change the way humans would react to and use it.   If we had 
> universal health care, it means that individuals would never see the 
> benefit of money saved? they would simply be given a ?blank check? in 
> terms of their health care and how they care for themselves? and therefore 
> dismiss risks with personal choices for their health.   I can tell you 
> first-hand my experiences on how human behavior changes as soon as fiscal 
> responsibility to pay is shifted to the individual as opposed to a 
> faceless 3rd party. It?s sounds heartless to say (and even harder to 
> defend)? but in order to have people making GOOD decisions, you have to 
> have examples of people making BAD DECISIONS.    Jay !
>  From: vision2020-bounces at moscow.com 
> [mailto:vision2020-bounces at moscow.com] On Behalf Of Donovan Arnold
> Sent: Wednesday, January 18, 2012 10:56 AM
> To: vision2020 at moscow.com
> Subject: [Vision2020] More Proof Preventative Health Care Saves Numbers 
> show high cost of skipping your medsNumbers show how skipping your meds 
> can have serious health impact, financial consequences 
> http://finance.yahoo.com/news/numbers-show-high-cost-skipping-214621515.html 
> "?Every dollar spent on medication decreases total health costs to 
> patients, insurers and government health programs by about $10.10 for 
> people with high blood pressure, by $8.40 for congestive heart failure 
> patients, by $6.70 for diabetics and by about $3.10 for patients with 
> cholesterol disorders." And what idiots would pass up $3.10 to $10.10 
> return on each $1 invested? The same idiots that pass up universal 
> preventive health care. The same idiots that believe it is better to pay 
> $10.10 of taxpayer dollars in medical treatment tomorrow than to a give 
> the person the opportunity of insurance to spend $1 on medication today. 
> But when your interests lie with the person who gets the $10.10, only then 
> it be!
> comes clear why denying them the insurance to get the medication is the 
> preferred action.  Donovan Arnold
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