Social Media: Meet the Flockers

In less than two years, the number of American adults who visit social media websites at least once a month has more than doubled. That’s nearly one-third of the population, or more than 55.6 million people. (Forrester Research)

Choices for social media involvement continue to multiply as well. Traffikd.com lists more than 600 social media and social networking sites in 39 categories.

Why are we flocking to social media in record numbers?

Individuals engage in social media to fulfill their own self-interest, according to Yochai Benkler, Harvard professor and faculty co-director of the Berkman Center for Internet & Society. He believes social media is a free collaborative network in which we define our individual needs and desires and act in collaboration that translates into personal fulfillment. Our motives vary. We may seek a solution to a problem, pursue interpersonal relatedness, reinforce our identity, or develop a reputation in anticipation of future work. (www.knightpulse.org/blog/09/07/21/why-do-people-join-social-networks)

I've identified five stereotypes of social media users that confirm Benkler’s assertions. How many seem familiar to you?

1. Wolves sell covertly with messages that appear to be helpful or educational, but often lack substance.

2. Climbers build reputations by posting incessantly to keep their name in the news.

3. Mavens fill our spaces with recommendations for everything from restaurants to rappers to revolution.

4. Boors lack respect for others, either from innate rudeness or lack of netiquette.

5. Blabbers share life’s every detail.

There's a bit of each of these stereotypes in all of us. We don’t merely use social networks; we are the networks. Seeking fulfillment, we flock together and create social media in our own image.

—Tom DeSanto

Image: social-media-expert.jpg from Google images

An Rx for Reform: VBID

Value-based insurance design (VBID) can help reduce healthcare costs and improve outcomes.

VBID reduces copayments for procedures and medications that meet evidence-based criteria for benefit and raises copayments for those that don't. The implications are enormous, especially for patients with diabetes.

The cost of treating diabetes in the U.S. amounts to more than $200 billion each year. (Associated Press/Novo Nordisk)

The least compliant diabetes patients are twice as likely to be hospitalized than the most compliant and their healthcare costs are nearly double. Each dollar spent on medication saves $7 in medical costs. (Medco study)

Patients with diabetes are significantly more likely to take medications for secondary prevention when their copayments are lowered, according to new study presented at the Society of General Medicine annual meeting. It provides solid evidence for the effectiveness of VBID. (Learn more at www.youtube.com/watch?v=JwI3effEnPE)

Advocates of VBID believe that the concept could make a significant impact in the Medicare population. Nearly 70 percent of Medicare spending comes from the 23 percent of the nearly 26 million beneficiaries who have 5 or more chronic conditions. Almost 20 percent of Medicare Part D recipients either delay or decline fulfilling prescriptions because of cost.

Imagine if we made the medications with the best evidence-based performance available at an affordable cost, so patients could be more compliant. The University of Michigan Center for Value-Based Insurance Design has been an advocate for this type of reform since 2005. Now policymakers are taking action.

Congressman John Dingell introduced legislation that includes provisions for modifying cost-sharing and payment rates that would encourage the use of services that are most effective in demonstrating value and promoting health.

Our healthcare system has many chronic conditions. Improving its health will require a bold and consistent treatment plan. VBID is one prescription that shows great promise.

—Tom DeSanto

Image: University of Michigan Center for Value-Based Insurance Design logo

Obesity: Let's Lose Misconceptions

Grim statistics on America's obesity epidemic and Wal-Mart's bold statement supporting healthcare reform were released on the same day. To me, it seemed very ironic.

I applauded Wal-Mart's stance in my blog, but cynically wondered if America's largest retailer might be faulted for the fattening of America.

I imagined huge numbers of large people buying vast quantities of discounted, unhealthy snacks. Could there be a correlation between the states with the highest percentage of obese residents and the number of Wal-Mart stores there? After all, aren't Wal-Mart stores concentrated in the South?

My search for truth eventually led me to an article entitled "Wal-Mart's Weight Effect" in the June 8, 2009 issue of Forbes. I found out that I was dead wrong.

Forbes reported that researchers at the University of North Carolina-Greensboro discovered that "greater consumer access to a Wal-Mart store was associated with lower body mass indexes and lower probability of being obese." How could that be? Their data suggests that when people gain purchasing power, they buy healthier food.

Shame on me. I now realize that many of us who don't struggle with weight are part of the obesity problem. Our misconceptions and stereotypes contribute to a lack of understanding of the complex economic, social, cultural and emotional issues that contribute to obesity.

We need to lose our unhealthy misconceptions about obesity before we can hope for a healthier, less-obese America.

—Tom DeSanto

Map: Trust for America's Health, AP

Wal-Mart Roars on Healthcare Reform

In a letter to the White House, Wal-Mart declared its support for healthcare reform that requires employers to provide health insurance to their workers. The company is enormous and so is its show of support, an opinion contrary to that of most large companies.

Wal-Mart posted FY2009 revenues of $401 billion and has 2.1 million associates worldwide. The nation's largest private employer has spoken. But is it fervor or fluff?

A recent Wal-Mart TV commercial proclaims that 94 percent of its full-time and part-time associates have health insurance and the company won't be satisfied until 100 percent are covered.  http://walmartstores.com/Video/Default.aspx?id=1340

More specifically, 53 percent are covered directly by Wal-Mart. The other 41 percent are covered under family members' plans or Medicaid (for 36,000 employees), according to the New York Times.

What about Wal-Mart's coverage? Its plan features wellness care, including mammograms, colonoscopies, flu vaccines and well-child care. It also boasts a personal electronic personal health record and comprehensive maternal health benefits for the 15,000 Wal-Mart associates who have babies each year. Wal-Mart seems to practice what it preaches.

Wal-Mart roars—and rocks—on healthcare reform. It's a dramatic turnabout for a company once known for low wages and few benefits. Maybe it's a shot in the arm that may give healthcare reform a shot at success.

– Tom DeSanto