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Digital Health
The Good, bad and ugly
 
Josh Mandel MD & Dr. Frank Byrne
Respondent: TBD
October 14, 2024

We tried very hard over the 25 years of our small software business to make healthcare just work for our colleagues.  No messing around with co-pays, deductibles in or out of network and so on.  That worked until about 6 years post Obamacare when our premiums cumulatively exploded by > 600%.    Welcome back to complexity, all.   


That experience drove me to pay attention - as much as possible - to what's happening behind the scenes.  And, indeed, there is much to understand.  Costs continue to explode while service seems to be an afterthought in our "billing, coding and medicating" era.   This article illustrates just one small part of the current system: "Most carriers in the state’s individual and small markets are raising rates by roughly 9% to 15%"

 

https://www.startribune.com/health-insurance-premiums-mnsure-blue-cross-blue-shield-of-minnesota-healthpartners-unitedhealthcare/601152986

 

Further, there's this: "The rate jumps, revealed in state data Friday, are bigger than during each of the past two years. They will be offset for many in the individual market by larger tax credits from the federal government if they buy coverage through the state’s MNsure health insurance exchange, officials say."  These sentences illustrate the front, back and side door methods used to pay for healthcare today - and mask some of what's happening via taxpayer subsidies of various kinds. (There are also subsidy recapture schemes through our annual tax filings!)


I've asked two terrific people to share their knowledge and experience on digital health.  

 

 Josh Mandel, MD is Chief Architect for Healthcare at Microsoft Research:

 

 https://www.microsoft.com/en-us/research/people/jmandel/

 

 https://joshuamandel.com

 

 

 Dr. Frank Byrne recently retired as President of St. Mary's hospital in Madison:

 

 https://www.wisconsinacademy.org/contributor/frank-byrne

 

https://www.ibmadison.com/in-business-madison/the-evolution-of-employer-sponsored-health-care/article_ee73ea8c-3870-11ef-8bcd-7728b5f1299b.html

 

 

In some ways, we are in the best and worst of times for healthcare.  The technology can be astonishingly good, while at the same time very frustrating.  

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