Posts Tagged ‘Healthcare For Everyone’

Health Insurance Exchanges: How will they work?

Monday, August 3rd, 2009
I keep seeing this in article after article about healthcare reform:
“Members of both parties in both chambers want to create health insurance exchanges, where people could shop for insurance and compare policies.”
http://www.nytimes.com/2009/08/01/health/policy/01health.html?_r=1&hp
What does this mean? Who will run the exchange? How will it work?
How are people going to shop for insurance and compare policies? Based on descriptions of the health plans we get from insurance companies today? That feels unsatisfactory. In my experience, even just choosing between the 2-3 plans offered by my employer felt random.
Are health insurance companies going to have to release more data about what they actually end up covering and how much people actually pay out of pocket per year?
Will customers have an opportunity to review these products and provide their own numbers as a reality check on what the insurance companies claim they will provide?

Grace's Bill - Left Side

Grace's Bill - Right Side

I keep seeing this in article after article about healthcare reform:

“Members of both parties in both chambers want to create health insurance exchanges, where people could shop for insurance and compare policies.”

What does this mean? Who will run the exchange? How will it work?

How are people going to shop for insurance and compare policies? Based on descriptions of the health plans we get from insurance companies today? That feels unsatisfactory. In my experience, even just choosing between the 2-3 plans offered by my employer felt random.

Are health insurance companies going to have to release more data about what they actually end up covering and how much people actually pay out of pocket per year?

Will customers have an opportunity to review these products and provide their own numbers as a reality check on what the insurance companies claim they will provide?

Above are 2 halves of Grace’s health insurance bill for June. (I wanted to make sure you could see all the details.) Can you decipher it? It’s for an eye exam and contacts! It’s also a sad example of what people mean when they complain that there’s too much paperwork in healthcare. How much $$$ was spent just processing this bill?

And this “bill” (an itemized statement of money owed for goods shipped or services rendered) doesn’t even tell Grace what she owes. She had to call to confirm. Apparently she owed $0. Go figure.

What inane billing stories do you have to share? Post them here! Read about why you should here.

How will healthcare reform affect me?

Thursday, July 30th, 2009
Is this really the most imaginative way we (the electorate) can think of to get in on the debate on healthcare in Washington?
Sometimes I wonder if the questions pollsters ask actively make things worse because they reinforce the vague feelings of fear people have about change.
Are you afraid that a government plan will take away your ability to choose your own doctor?
Are you concerned healthcare reform will increase costs?
Why are we passing legislation based on people’s fears?
Isn’t the human condition all about fear of change?
If that’s what we’re going on, why would we ever pass any legislation?
This is useful for helping Washington identify what fears to address (or play up).
But it isn’t particularly useful for figuring out how to address those fears.
What’s needed is a way to connect the dots from our individual situations to the wonky plans and provisions floating around Congress.
And I don’t just mean a personal calculator to figure out “How is this plan going to change my personal healthcare experience and healthcare costs over the next year, 5 years, 10 years, 30 years, lifetime?”
To successfully connect the dots, there needs to be a way for us to engage in a conversation that builds and evolves as old issues are resolved and new issues arise. Thus far, the way this has been attempted are with story forums and town hall meetings. But as I explained here and here, there’s only so much we can glean from reading stories and watching Obama go head to head with a handful of individuals.
What’s needed is a dialogue between all the major stakeholders that is mediated by data (from all stakeholders). Data we offer up about our own particular circumstances, matched by data from insurers, data from healthcare providers (hospitals and doctors) and data from the government.
Again, we
But also how is this plan going to change healthcare for everybody. Believe it or not, we *can* be goaded into making sacrifices for the greater good, provided we can be convinced that greater good will come of our sacrifices and our sacrifices are the only thing standing in the way of greater good. In other words, everyone wants the best for society. We just don’t want to be the only ones who get screwed along the way.

NYT / CBS Poll

Is this really the most imaginative way we (the electorate) can think of to get in on the debate on healthcare in Washington?

Sometimes I wonder if the questions pollsters ask actively make things worse because they reinforce the vague feelings of fear people have about change.

Are you concerned that a government plan will take away your ability to choose your own doctor?

Are you concerned healthcare reform will increase your personal healthcare costs and up your taxes as well?

Of course I’m concerned! Who wouldn’t be?

Why are we surprised by such concerns (aka fears)? Isn’t “fear of change” intrinsic to the human condition? Who’s really going to come out and say that they’re confident that any plan is actually going to work? (It makes me wonder if these polls are really more useful for understanding who’s optimistic and who’s pessimistic than anything else.)

Still, this kind of polling is useful for helping Washington identify what fears to address (or play up). But it isn’t particularly useful for figuring out how to address those fears.

What’s needed is a way to connect the dots from our individual situations to the wonky plans and provisions floating around Congress. A way for us (individuals) to engage in a conversation with legislators that builds and evolves as old issues are resolved and new issues arise.

Thus far, attempts to connect with the electorate have primarily consisted of polls, story forums and town hall meetings. But as I explained here and here, there’s only so much we can glean from reading stories and watching Obama go head to head with a handful of individuals.

Instead, what if we could participate in a dialogue mediated by data?

Data that gives each of us a picture of what our situation is today versus what our situation will be post-reform. (Where “our situation” includes both our individual circumstances and our fate as a society. And “situation” means numbers that are specific to us, not averages that aren’t actually relevant to anyone.) Generalized reassurances from politicians aren’t enough!

Come to think of it, isn’t this the kind of basic transparency into government we should be demanding of our elected representatives?

What would we need to have such a dialogue? We, the people, need to offer up data about ourselves. But insurers, healthcare providers (hospitals, clinics, doctors) and the government would have to do the same.

We understand that “data” is too often cited as as an ambiguous cure-all. So to be more specific, we think something like our demonstration online data collection forum would’ve been a modest, but potentially more meaningful way for the “public” to reach out to legislators.

Healthcare For Everyone: Stories versus Data

Friday, July 24th, 2009

In my last post announcing our demo site “Healthcare for Everyone: An online data collection forum,” I talked about how “hard data is especially important when there is a profound disagreement over the nature of a problem.”

You might ask, don’t we have lots of hard data already? Certainly pundits and politicians alike are quoting a lot of statistics these day.

$46 million uninsured

$15,000 per capita per year on insurance, $6500 more than other rich nations

Still, these numbers are failing us. Why?

Because they fail to paint a picture that let’s us see the people behind these numbers. (Let’s ignore accuracy for now.)

They are Coarse Aggregates (46MM uninsured) and Banal Averages ($15,000). They are relevant to everyone and as a result, they are relevant to no one.

Who are these uninsured? What are their circumstances? Are they old or young? Poor or rich? Men or women? Parents? Single parents? Immigrants? Urban? Educated? How many “chose” to be uninsured? How many were rejected for coverage?

Who’s spending $15,000? Do they have pre-existing conditions? Is it out of pocket? Or are their employers footing the bill?

On the flip side, there are also a lot of people sharing their personal healthcare horror stories online. Here are just a few places where it’s happening

http://healthcareforamericanow.org/site/your_stories/P1220/
http://standupforhealthcare.org/page/s/story
http://stories.barackobama.com/healthcare/

http://ehealthforum.com/health/health_insurance.html
http://answers.yahoo.com/dir/index?link=list&sid=396545321
http://forums.about.com/n/pfx/forum.aspx?webtag=ab-healthins
http://christianscience.com/forums/showthread.php?t=176
http://www.topix.com/forum/health/health-insurance

Yet, in their own way, these stories are also somehow not enough. Who are the people behind the posts? Not literally “Who are they?” as in “What are their actual identities?” But what are the specifics of their situation? Are they like me? How common are their experiences?

So it was gratifying to find these 2 forums on fertility and cancer, because hard data about each contributor contextualizes every post. (An outsider might find it difficult to understand what’s going on, but clearly a wealth of data is being offered up and consumed by those who frequent these forums.)

Fertility Forum

Still, even these data-rich posts leave me wishing for some way to see in toto: “Who’s in the forum?” and “What are they grappling with?”

Without some such aggregated “picture” of what’s being shared in these forums, how do any of us begin to see the sum and significance of all these stories?

We don’t pretend that our little demo site is going to paint the picture of what’s going on with healthcare in the U.S.

But for those who chose to contribute their data, we think our approach already does a better job of painting a picture of their healthcare situation (individually and as a group) than the forums and healthcare data reports we’ve seen so far.

Me and Everyone Else

Healthcare Stories (and Data) for America

Wednesday, July 22nd, 2009

Healthcare For Everyone: An online data collection forum.

As part of our work, we’re experimenting with ways to motivate people to donate data about themselves, either to further a cause they believe in or simply to better understand their situation relative to others. We’ve built a demo site around the issue of healthcare and would love for you to try it out give us some feedback!

Of course, we’re not the first people to have a go at organizing people around healthcare online. The Obama administration’s recently launched Healthcare Stories for America is particularly well-done, with an interactive map and community-driven mechanism for highlighting especially interesting contributions.

Healthcare Stories for America

Still, we wonder if we shouldn’t take it up a level.

Our belief is that to make a compelling case for any issue, especially one as complex and multi-faceted as healthcare, you need both:

  1. Real stories to humanize the problem; and
  2. Hard data to contextualize those stories and provide handles for understanding the size and shape of the problem.

It is no accident that the interactive map is most prominent way to browse “Healthcare Stories for America.” We think there should be even more “data-driven” ways to soak up what people are contributing. Far from being a turn-off, we believe that asking people to give more data can make community forums more compelling and more engaging, provided people understand what they’re giving up, who they’re giving it up to, how it will be used and see an immediate pay-off for themselves.

The basic assumption of the site is simple: Give data. Get more data.

The visualization below is a static example graph of how we imagine more “data-driven” ways to consume and make sense of the kind of information people are sharing on forums like “Healthcare Stories.” See full-sized graph here.

Static Example Visualization

Hard data is also especially important when there is profound disagreement over the nature of a problem. This is the the drama that is playing out in Washington right now over healthcare. Hard-won, at times grudging agreement that reform is necessary counteracted by entrenched disagreement over exactly what the problem is and how it should be addressed.

So please take a look at what we’ve done. Browse around. Contribute your story. Our privacy guarantee is simple. Either you choose to make your information public, or you don’t. If you don’t, we will never release your data except in aggregate form, like this and this.

Let us know, what’s compelling to you? What’s not? What would you like to see more of? less of? What questions do you have about how the site works? Feel free to post your comments and questions here or email us directly at info [at] commondataproject [dot] org.


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