The central player in health care is the physician, both primary care and specialist, yet proposals, speeches, experts, never directly address the physician's role in controlling cost and improving quality. The prize should be awarded to the plan that gets physicians involved in the effort. Any other plan will fail.

Any effective solution to the Healthcare crisis we face, has to address the real souce of the problem. I am one of the millions who have added to the Healthcare problem that we all now have to deal with. Several decades of my lack of taking responsibility for my own health, resulted in several diseases that required, and still do, very expensive Healthcare. Insurance had to pay most of the cost, which has contributed to the affordability of insurance costs nationwide I can only imagine how many millions of people who are now doing exactly what I have done. All of the diseases I eventually developed were avoidable, had I fully recognized my own responsibility. How do you actually reach all those people that currently don’t give nutrition a thought? The only way most get any information or education is via TV. Are we serious enough to have the Govt go to the expense of using it? Are TV companies willing to air ads that may directly conflict with certain advertisers? Would the Govt. be willing to institute a program for example called “Good Choice” where when people shop for groceries, that get a credit to an account for making good food choices. Money for these accounts could come from producers of “Good Choice” foods, Companies that recognize the value of healthier employees, etc. These accounts could then be used to help cover co-pays on care or drugs. Something like this would be complicated, but in today’s world, technically possible. Dr David Katz, of Yale University, has some initiatives in operation, that if they were ever to be widespread, the health care demand would be lowered, the cost of Insurance would be lowered, and the overall Healthcare System, might eventually be able to cope with our health care needs. Just a thought.

Your health is your choice!

First of all, let me applaud you for taking the initiative to use open innovation techniques to collect ideas that help to build a better system - IBM, P&G, Dow, Lilly have all shown how effective this can be.

In developing your criteria for a prize, I encourage you to consider all of the aspects of business model innovation - solutions should provide new answers to the questions of - who does the system serve, how does it serve, where does it serve, how does it generate profitability (both revenue and costs), and how do you sustain a competitive advantage.

There are also many unspoken beliefs and uncovered customer insights in health care today (for example, large insurers can not own the delivery/provider part of the value chain). Your prize should challenge innovators to identify those unspoken beliefs and validate their customer insights in their proposals.

DJ

I am a person who uses my health insurance, as far as health insurance I do have the best. I think the WASTE, FRAUDand ABUSE of medical insurance needs to be addressed, as well as the need for a better more accesible records system. I will give you a example; I get chronic kidney stones and infections due to hypercalcuria for years now. In going to my UROLOGIST, he set up a cystascope. Well before I got it he died. I could not get in with any UROLOGIST in my city for at least 6 months and was in much pain. I then returned to primary care and told them I was in pain and told of the kidney problem and the following are the services I recieved; A PAP SMEAR - A RECTAL EXAM - A UTERUS BIOPSY- A MAMOGRAM- A SURGICAL PROCEDURE D&C. and no one addressed the kidney problem nor did they try to send me to a UROLOGIST,or give me anything for my pain. I had to find another uroligist in a nearby city who would accept my insurance plan. But not before I was subject to all these (I feel ) un-needed services. Had there been a more accesible records system that can move from DR to DR these un-needed services may have been Questioned by someone and money would have been saved. This is not the first time I feel my Insurance has been MILKED for un-needed services costing many $$$$$$$. We need a better record system not more privacy.

To Promote Competition Based on Service and Product Quality: We need transparency on both sides of the equation. Medical Providers (Hospitals, Physicians, Drug Companies, Implant Vendors,etc.) should be required to post their charges publicly just like any other service provider does (food, clothing, cars, etc.). Payors should post their standard fee schedules publicly as well. We should have standard quality metrics applied nationally to all providers and it should be posted publicly so patients know what kind of provider they are accessing. Payors claim turn around time, denial of payment patterns, customer service scoring should be applied as a national standard and posted publicly as well. All Providers of Medical Care should be able to have a "cash upfront - paid at time of service" fixed rate schedule for the non-insured and payors should not be able to contractually require that they be granted the same schedule. To Promote Fair Reimbursement For Indigent Care: To help the hospitals out with indigent care costs, anyone appearing in the ER without a valid insurance/ health care coverage card or money/credit card to pay for the services should submit their social security card to prove they are a legal resident of the United States and paying into the tax pool. Claims for such services should be paid in full (not a %) by the government and the government should be tasked with chasing down the reimbursement from that person to recoup the cost of care and not leave the hospital to cover the uninsured. Anyone presenting in the ER that cannot prove they are a legal resident of the United States should be required to submit their fingerprint and a local county immigration officer should interview the person post care. This proactive assistance from the government would be helpful in keeping hospitals solvent financially and will help keep track of who is paying into the tax pool and who is not paying into the tax pool yet reaping all the benefits of the rest of us that give a third of our earned dollars to the government.

Lynn Consulting Services, LLC
Web: www.LynnConsultingServices.com

My suggestion is as follows- focus the prize on Clinical Diagnostic Decision Support.

prior state-of-the-art:
MYCIN- Stanford project 69% accurate, able to outperform human.
TREAT- UofCopehagen, 85% accurate, able to outperform human.

specifications:
Focus on the top-ten diseases; parameterize human accuracy, off-the-shelf computational accuracy; determine complexity of problem; provide developers with standardized data set; set threshold for challenge; make solution known/open-sourced for verification. The data set should reward accuracy to cost for tests used (ie if an expensive test is needed for certain accuracy vs if just cheap blood test can give better ratio). Finally, treatment should be optimized to fit drug interaction parameters, compliance and behavior (ie given patient personal profile, how likely will they do the treatment, analogous somewhat to netflix movie recommendation prediction), and other treatment prediction paramters.

impact:
By automating the treatment process for heart disease, neoplasms, CV, respiratory, diabetes, Alzheimers, kidney, influenza/pneumonia, and sepsis, to a level better than a human- accessible, affordable, asynchronous health care can be obtained.

If a xPrize is set up with rigor complexity requirements, appropriate data set is provided, and solution is open sourced, then many in the Machine Learning community will compete.

I believe having a way for patients to organize all of their medical data under one system for rapid access would benefit them greatly. I am envisioning a double-blind system that does not permit the organization in charge to know who's medical data matches up with what patient but allows demographics to be kept for statistical research.

A privately owned highly secured database that hospitals, doctors offices and EMTs could access which contains a patients entire medical history accessible from even a mobile location such as an ambulance could make diagnosis and error avoidance much easier. If a doctor had access to a patients medical history while they are enroute to the hospital as well as telemetry from the ambulance could assist the staff in making decisions on treatment in advance of the patients arrival.

Michael Schwartz
Your prize for new approaches to health care reform should embrace not only many of the ideas I see here in these comments and in the plans of those running for high office, but should take a fundamental systems change approach and offer not only relatively short term actions to relieve current stresses, but a long term sustainability plan. I intend to submit just such a plan when the contest opens and look forward to seeing many new ideas offered. We need them.

This is the third time I am trying to post. I keep shortening it!

We need prevention in our system. This is only one component, but important.

I am not a healthcare expert per se. I am a mother who cares about the health of my family.

Please visit www.westonaprice.org to see how DIET can improve and eliminate health problems. My story is anedotal, but I experienced profound beneficial improvements to several health problems (so did my husband) through eating traditional foods prepared in traditional ways. Our only supplement is cod liver oil. We do not and have not taken any medications.

No sugar, no soda pop, no processed foods and my children (ages 7 and 4) have NEVER taken an antibiotic. They have gotten occasional colds, flus like any other child, but not severe.
We eat full fat meats, eggs every day, cheeses, butter slathered on everything and raw milk as well as fermented foods. Not one of us is obese after three years of eating like this. (The twelve years before we started eating traditional foods, we were vegetarians following government recommendations for eating a "healthy lowfat diet", and we got sicker and sicker...!)

Many would call me simple, naive, but I would be happy to tell the details. I AM better from a condition that our medical system says requires surgery. My husband can play golf now after years of not being able to move his shoulder joints. Yes, the process was slow, we noticed changes after about 18 months, but we are still drug free at ages 46 and 55.

We need to emphasize prevention of disease by eating a nutrient dense diet. We are overfed and undernourished! Why are so many children and young adults and seniors taking drugs? People need real, whole foods, not processed, food colored, dead foods. I know that diet is highly controversial for most people, but seriously, we are what we eat.

Finally, we are both self-employed and we have struggled to pay for health care. Despite the fact that we do not use the system much at all (school physicals) our premiums keep rising sharply each year. We also have a $5,000 deductible which we have never come close to reaching (thankfully).

The key to sustainable health care reform is controlling/reducing the cost of care. One of the prize criteria should assess how well this is done.

Dave

An important "ground rule" to consider when developing an improvement strategy for healthcare pricing and revenue distribution is that all parties have a fair share of any profits realized - both PROVIDERS and PAYORS. Additionally, competition needs to be alive and well to keep the costs down. Payors should NOT be legally allowed to REQUIRE most favored nations pricing from their provider network participants. This only runs the smaller payors that cannot demand such arrogant actions out of business and reduces the competition and also reduces the business activity in the market as well (thereby reducing jobs and business taxes which has a ripple effect on that market's economy).

Lynn Consulting Services, LLC
Web: www.LynnConsultingServices.com