So we’ve done it. After months of work, debate, bug squashing, and not a small amount of caffeine, we have launched the new user interface for MedBillManager. We have done our best to make the new interface intuitive, fun, and most of all, flexible.

One of our biggest realizations throughout the development process has been that no two users are going to think of their medical expenses in the same way. Some people think of them in terms of family members. Others think of them in terms of the reason for visit. Still others think of them in terms of the provider visited. We have done our best to ensure that no matter how you think about your medical expenses, MedBillManager will be able to accomodate you.

I’m not going to sit here and blab about all the great new features we have built in, for that you can head on over to the splash page, or go ahead and sign up for a free trial. But let me assure you, there are a TON of great new features in the new MedBillManager.

Christopher, Katrina, Robert, Beale, you all deserve a HUGE pat on the back for making this a reality. Without all of you guys this never would have happened. Congrats to the entire team.

Everyone out there, I highly recommend giving MedBillManager a try…I promise it will make managing your medical expenses MUCH easier, and it is a great first step towards putting the power of healthcare back into the hands of consumers.

So who’s to blame for America’s healthcare problems? In part 1 or my 2 part series, I had told you the reasons why I feel that individuals and physicians and health practitioner deserve some of the blame for our systems complications.

Note: www.charlesclarknovels.com made a wonderful comment on part 1, highlighting accountability (if you’re interested go back and read his comment on part 1). In an industry dominated by tiers of power, responsibility plays a part. However, accountability may be more important. Its one thing to be responsible for your actions, its another to be accountable for the way in which they effect others. And yes unfortunately, Stark is taking a very long nap, and many individuals are taking advantage of his slumber.

Moving on, I have two more culprits to add to my first two. Here it goes…

3.) Insurance companies

Insurance costs and the industry’s connection to employment (which is unpredictable and unstable) make private health insurance primarily available only to the middle and upper class.

As companies began to focus on experience rating and classifications of employment, individuals with minimal income or chronic health conditions have been increasingly pushed out of the private insurance arena. The cost burden of private insurance has been shifted to the employers who continue to push the additional costs directly to their employees. Individuals with the increased burden of medical problems are having to additionally handle the increased cost burden of the industry.

Arguably though, the biggest problem with insurance companies rests in their organizational structure. The solutions this industry was intended to provide have alternatively enabled the rising cost of healthcare. Rising costs have directly led to higher premiums and deductibles that place a financial burden on the individuals with private insurance.

4.) The Government

All and all, I would have to argue that the government deserves most of the blame for America’s confounding healthcare problems. Though Medicare and Medicaid have improved care to the elderly and the impoverished, the programs simply fall short of providing a solution. Still to this day, after Medicare and Medicaid were created more than 40 years ago, a large number of patients remain unaware of the services and care options afforded to them through these government programs.

Not only are patients suffering from the lack of a unified and reliable government healthcare program, but the institutions providing the care assume the burden. Under funded and struggling with the uninsured, many institutions are taking responsibility for individuals’ lack of coverage. Unfortunately there isn’t even a set amount of government money given to health institutions to defray the cost and burden of treating the uninsured. This places many medical institutions on the verge of closing every year, which would only furthers the burden on the system…

Recently Michael Moore attempted to tackle “who’s to blame?” As many of you know he has quite the art for blaming big institutions like the government and insurance companies. Unfortunately, its not that simple. Practitioners and individuals deserve some of the blame as well. But ultimately I must point my finger at the fact that our government has allowed individuals and practitioners to absorb the burden of their continued lack of unified involvement. If the government were to take more responsibility for the current problems of our system, then the other parties could not opt out of the blame. Each of these sectors, individuals, practitioners, insurance companies, and the government, contributes to the problem in their own unique way.

Our healthcare system needs a reevaluation of responsibility and collective reform of the system in all four of these sectors. Individuals need to begin to take more responsibility for their health, practitioners need to follow up and stop blaming the system, insurance companies need to consider alternative methods of coverage, and most importantly the government needs to begin to view healthcare as a basic human right before any real changes could be made.

I had to bookmark and capture this terrific post on Found+Read by Mike Simonsen that addressed in a simple sentence what Health2.0 start-ups need to do in order to validate their service development ideas [and quite frankly, we haven't done a great job of this either... but we will NOW].

Mike writes:

Everyone founder knows they need to “talk to customers” and “get customer feedback” before they get too far…What’s less well understood is that customers often give lousy feedback. They’re unimaginative, stuck in the status quo, and distracted. They already manage their day without your product, and life will go on if you don’t exist.

How to guarantee that you’re getting good information out of your customer conversations?…Use the Present Tense.

When conducting reconnaissance with customers for your as-yet-unbuilt product, speak about it in the present tense. This is what the product does. This is how much it costs. (Even though it doesn’t, yet.) And be specific.

Definitely never ask: “What do you want the product to do?” or “How much would you pay?” Customers have no idea what they want. But they know they don’t want to pay for it.

Rather, when you use the present tense, you get immediate, usable feedback. In fact, the more specific you are about what your product “does” now, the better your results will be.

Mike – I’m sorry to have clipped so much of your article, but i wanted people to see the true gem of an article that you posted! The best part of his post are his examples of using this approach for product/service development…definitely go read the whole post.

The irony of Mike’s post and a multitude of conversations that i have had with potential partners and friendly competitors is that NOBODY has taken Mike’s approach. In the Health2.0 community of companies, there is a general feeling of “we know healthcare and what consumers NEED.” There are multiple companies that are attempting to “consumerify” [a term i just made up] or taking current clinical-focused healthcare applications/processes and try to convert them into consumer-friendly versions of aforementioned applications/processes.

Additionally, there are a multitude of healthcare organizations and employers that are trying to offer patients/employees valuable information, increase transparency, and embrace technology such as giving consumers access to their doctor appointments, clinician’s profiles, medical notes, and other health-based information. But as an industry, are we asking people who don’t know what they want, what they wish they could have? I’m not implying that Personal Health Records and other medical information access/storage/sharing mechanisms are ill-gotten pursuits. In fact, i am certain that most companies are focused on the correct “what“. I’m just not certain that we are figuring out the “how” very well.

I honestly don’t have any answers… but i think that i will be much better suited to gain customer feedback by presenting our product/service development ideas to customers in the present tense:

Another example from Mike’s post…

Hypothetical:
You: “What what would you like our product to do?”
Customer: “What I’ve been thinking about is…X, Y, Z.” (Read: something totally wacky and way outside your vision or expertise.)

Present Tense:
You: “We’re building our company, here’s the problem we saw. So we built Product X. It does this and this and this.”
Customer: “But does it do X, Y, Z?” (Read: completely obvious incremental feature that you’ve totally missed so far.)
You: “Not yet, but that’s a great idea. Tell me more. How/when/why do you need that?”
(By your next customer meeting you can decide if the product “does” that too!)

Social networking…

Could there be a more abused buzzword? (ahem, that was a rhetorical question as i am sure there are many more out there). From Facebook to MySpace to a variety of other social networks (heck let’s throw in Health 2.0’s OrganizedWisdom, Patient’s Like Me, and DailyStrength just for good measure) recently it has become apparent that people like to share with other people. I came across a great blog post by Jane Sarasohn-Kahn of iHealthbeat titled Drug Companies Lag in Adopting Social Media To Communicate With Consumers.

First a big hat-tip and thanks to Matthew Holt’s and John Sharp’s blogs:

John’s succintly points out…

the companies could learn much from their patients using this medium. There is also potential to enhance compliance – perhaps patients could learn from each other more about how to manage a chronic condition like diabetes.

Matthew also pontificates…

These BTW are good things for drug companies and patients

Let’s get into the meat of things though, Jane (who knows how to craft an article!) leads off with a true “head-scratcher” …

As many as one in three U.S. residents with diabetes were taking Avandia in May 2007. That translates to somewhere between four and five million U.S. residents who might have been Avandia consumers at the time when Steven Nissen’s study linking Avandia to risk of heart disease was published in the New England Journal of Medicine.

After the study came out, FDA, GlaxoSmithKline — Avandia’s manufacturer — mainstream media and television lawyers created a cacophony of conflicting information. However, a significant number of patients found information solace in blogs, wikizines and other consumer-generated media.

And i especially liked here interview quote from Grant Bruce…

It appears that in the current environment, drug companies are throwing the proverbial baby out with the bathwater when it comes to using social media to impact patient health behaviors. “The risk for the industry [in not taking advantage of social media] is that there is a baby in that bathwater,” Grant said, adding, “Pharmaceutical marketers need to understand this new environment and be aware of the ongoing discourse that’s out there” among consumers, providers and analysts.

But the real nugget that jumped out to me was this…

Patients today have lower regard for content created by pharmaceutical companies than they do for information generated by advocacy groups, physicians and fellow consumers. A Kaiser Family Foundation report found that 18% of consumers “most of the time” trust what pharmaceutical companies say in their ads — a much smaller share than in 1997, when 33% said they could trust drug company ads “most of the time.”

HOLY COW!! I understand the fear of litigious patients and the nature of informality that is often persistent in social-networks, but come on guys… it would appear that when embraced – these networked forums (if you will) have the potential to provide tremendous benefit and reinforcement of behavioral changes and prescriptive compliance.

Can someone send a copy of the Cluetrain Manifesto to the Pharma gang?! “…enables people [patients] to have “human to human” conversations, which have the potential to transform traditional business [pharma] practices radically.”

Jane – great article, well put together, and well worth the time to read.

and insightful, and good-looking, and well mannered… [ok, enough kissing up]

Really appreciated Hank of InsureBlog posting an unsolicited mention about FindYourDoc. People doen’t realize that it has free info (ahem… let me say that again… no charge, zip, nada, doesn’t cost a dime) such as where your physician graduated from, where they did their residency, what specialities they are board certified in…

But what REALLY gets interesting is the hospital data… inpatient and outpatient charges, negotiated rates, and costs… what zip codes patients are coming from to use that hospital. Yeah, we could make up something to make it seem super secret or psuedo-insider only info (think of it that way if it makes you feel better) but really – and be honest – wouldn’t you want, wouldn’t expect to know that information about your doctor or hospital BEFORE you got your bill.

Transparency is coming and it ain’t perfect but it’s coming nonetheless. Hang on.

Heck, if you use FindYourDoc to look up a physician or hospital, send us an email of why or how you used the information and we’ll post the top 5 stories… also, in the next 60 days FYD will get a new look and more quality data.