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Getting Real About Health Care Value

Tuesday, May 12th, 2009

It's time to have some real dialogue around the issue of health care value in this country. New information from the Spectrum Health Value StudyTM provides a mirror of what the America people value when they are spending their own health care dollars on health care for themselves and their families.

Although there is plenty of discussion about health care access and quality, the fact is health care is a three-legged, not a two legged, stool. Access and quality must be steadied by value in health care. Without value, people don't know what they are buying and/or they fail to understand the relative value of health care services like immunizations, a visit to the doctor or a trip to the emergency room.

Today we released the results of a new study on how Americans value health care. The study reports and additional information can be found at our website www.healthvaluestudy.com. We will continue to conduct the study on a quarterly basis to grow the data and better understand - and hopefully inform, the debate on health care reform.

We did this study because we were curious about how Americans value health care services. Our findings include some surprises in areas including:

  • mental health value
  • preventive health services
  • nutrition and
  • access

Last week, GE announced a six billion (yes, with a "B") dollar program to improve health care. GE chairman and CEO Jeff Immelt was quoted as saying, "Health care is an important industry that is challenged by rising costs, inequality of access and persistent quality issues."

Again, the discussion is around access and quality with no mention of value. When you are preparing to spend six billion dollars, one would think you would be somewhat concerned about value! We want to be that 'someone' talking about value. We hope you will join the dialogue.

Audrey Spolarich, Senior Research Advisor

Posted in Health Care Reform, Health Policy, Public Affairs, Research
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Audrey
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Dispelling the Myths of Pandemic Prevention

Thursday, April 30th, 2009

Swine Flu is all over the news - countries are imposing major travel restrictions to Mexico, and the CDC has reported 109 cases in the U.S. as of Thursday at 11:00 am.

The current situation reminds me of an article by Philip Alcabes in the Washington Post titled, "5 Myths about Pandemic Panic." Alcabes questioned the efficacy of looking to the past for ideas about how to prevent future pandemics, and challenged the following myths:

  • 1. Infectious diseases are spreading faster than ever;
  • 2. To learn to prevent a pandemic, look to the past;
  • 3. We should brace ourselves for another Spanish Flu;
  • 4. The annual flu season is nothing compared to a pandemic; and
  • 5. There's no such thing as being too prepared

Reuters also published a piece in March questioning the risk of pandemics and there was an article in the Journal of Emerging Infectious Diseases in February suggesting that it was strep, not the Spanish Flu, that killed millions during the 1918 Global Flu Pandemic. The JEID article suggested that had antibiotics against strep been available, many of those people would have survived.

There is now a general feeling that infectious diseases are emerging at alarming rates. Over the next few days we will hear more on the facts about how Swine Flu made it across our borders from Mexico as CDC goes into full swing on contact tracing for the U.S. cases. This is where I think Alcabes' piece is most relevant. Alcabes wrote:

[W]e run the risk of doing more harm than good by overreacting to the threat of a pandemic. In 1976, swine flu, a strain of influenza similar to the one from 1918, was diagnosed in a small number of soldiers at Fort Dix, N.J., one of whom died. That prompted medical experts to warn that the United States faced a crisis reminiscent of the Spanish flu. President Gerald R. Ford authorized a mass inoculation program, and 45 million Americans -- more than 20 percent of the population -- were vaccinated.

What I enjoyed most about his article was his attempt to debunk the myth that there is no such a thing as being too prepared in terms of pandemic prevention. He believes that we are spending too many resources on useless preparations. This "trial" run of an emergency response to a serious public health threat may help settle the question of whether the risks associated with a public health emergency, such as the one we are facing with the swine flu, are really worth the investments we have made in preparedness for a biological threat.

 Audrey Spolarich, Senior Research Advisor

Posted in Disease Awareness
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An X-Prize for Health Value?

Monday, April 20th, 2009

On April 13th, the X Prize Foundation, famous for encouraging serious tinkering around things like robots that go to the moon and cars that get 100 MPG, announced a $10 million prize for developing a plan for a community that "dramatically improves health value."

But how do we, or the judges of the X Prize, judge health value? How do we measure the current state of health value in a community - or a country - and how do we measure whether or not changes move the needle toward a greater health value?

This is a question of great interest to me and to Spectrum. We decided over five months ago to begin to address this question. Yesterday we announced the methodology for our Spectrum of Health Value StudyTM. Our study will directly ask Americans how they value various health products and services when spending their health care dollars. While the first data release is scheduled for mid-May, the preliminary results are very interesting.

The fact is health care is a three-legged stool - although this may imply more stability in the system than actually exists! One leg is quality of health care. The big debate around quality is the fact that we pay for much more quality than we receive. Furthermore, quality appears to be something that varies a great deal from place to place, as was outlined in testimony by now OMB Director Peter Orszag when he appeared before the Senate Finance Committee on July 17, 2008.

Access - another leg on that stool - also is a much discussed topic, but when most people discuss access to health care products and services they are really discussing Americans' insurance coverage, or lack thereof.

Only recently have policy wonks been batting around the question of health value. In his testimony before the Senate Finance Committee on September 9, 2008, Peter V. Lee, Executive Director for National Health Policy of the Pacific Business Group on Health testified on "Promoting Quality and Value in Health Reform."

These three legs - access, quality and value - will continue to dominate the discussion around health care for the months to come. We hope you stay tuned for this interesting and important dialogue.

Audrey Spolarich, Senior Research Advisor

Posted in Congress, Health Care Industry, Health Policy, Research
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Carrying the Water for a Social Marketer (and yourself)

Tuesday, February 24th, 2009

What, really, is social marketing?

Since the phrase first started to be kicked around in the mid-90s there have been many ‘experts' who have defined the term, on both sides of the pond.

In fact, the United Kingdom includes social marketing in the development of many of their social policies, particularly their health care policy. They believe that they have a very good idea what social marketing is.

I, too, consider myself something of an expert in social marketing, having been involved in social marketing campaigns since 1995, many of them spanning a number of years with major positive outcomes. I was involved in the social marketing effort of children's health advocates from around the country to call for passage of the Children's Health Act, which was signed into law in December 2000.

So, what is social marketing?

I like to use a little metaphor to explain what social marketing is. This approach works well, especially when attempting to explain the concept to the very people you hope to involve in the campaign itself, like veterans. I start by asking them if they remember when they first read Mark Twain's Tom Sawyer. Near the beginning of the book there is a chapter where Tom wants to go fishing but his Aunt won't allow it until he has white-washed the fence around her house. Tom is bewildered. He has no interest in the onerous task. Then a brilliant idea occurs to him. He rounds up all his friends and proceeds to explain to them how white-washing his Aunt's fence is the most exciting and fun activity that they could possibly imagine for that fine spring day. Soon they are all busy, brushes in hand. Tom is discovered, supervising, from under the shade tree nearby.

This is social marketing: Getting other people to carry the water. Making it seen as though carrying that water is the most important, most useful, most gratifying thing they could do with the time available. However, to be ethical, the water must be their water, you are simply motivating them to do what they need and hope to do anyway.

Along the way, you help them refine their message - a key part of social marketing - so that they are not going before key decision makers with the same old tired story about their cause and its needs. You help them carry their water to state houses and to the federal legislature by making their cause fresh and new. By helping them to develop the exact phrasing of what they are asking that legislator or policymaker to do exactly. Most important you teach them when it's time to leave and when it is time to follow up.

If you have questions about social marketing or how your organization or advocacy organization could use social marketing techniques to advance your cause, write me at aspolarich@spectrumscience.com.

-Audrey Spolarich, Senior Advisor

Posted in Community Involvement, Disease Awareness, Public Affairs
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