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Zen and the Art of Motorcycle Maintenance

Somewhere near the beginning of Zen and the Art of Motorcycle Maintenance, the author, Robert Pirsig, mentions Newton’s Law of Gravity. The author asks (rhetorically it turns out) whether this law of gravity always existed, or whether it was born in that eureka moment when Newton sat under an apple tree in 1687.

Of course it always existed.
This was my first reaction.

It took 200 pages for me to understand why I was totally wrong.

Hang with me here, and I can save you 200 pages of reading… or I can cause you 200 pages of reading depending on how you roll. …


This is a transcription of Relentless Health Value podcast Inbetweenisode 27 from July 4, 2020 —

This past March, I was looking forward to giving a keynote at the Arizona Technology Council. Unfortunately that didn’t happen. COVID happened. But in the process of figuring out what I was going to talk about during that keynote, I came up with an idea and I wanted to share it. It’s the idea of how to measure value in health care delivery — because you might as well go big or go home, right?

The metrics that we use to measure value are critical. And not just because what gets measured gets managed. It’s because American health care is the biggest, most impressive display of game theory anyone anywhere has ever seen. …


You may have insurance or you may not. The cost of your surgery is going to come out of your pocket anyway, either directly or indirectly.

If you don’t have insurance, then the math is obvious. But sometimes people with insurance don’t realize the cost they’ll be obligated to pay — until the bill comes and it’s too late. At that point, you already bought it and you might owe thousands of dollars.

For example, maybe your surgery benefit is “co-insurance.” This means that you pay a percentage of surgery costs. If the surgery costs $25,000, then you might owe, say $5,000. …


Before we get into this, let me state for the record that this article has nothing to do with whether there is a war on Christmas, or whether Mick Mulvaney is in obvious distress.

This article is also not intended for anyone who believes that our entire government is a sham and every single “mainstream” journalist is in some kind of giant canoodling club that meets over huge teleconferences and hatches nefarious plots to trick everybody.

I’m quitting Facebook, by the way. Every time I log on, I grit my teeth and get a stomachache. Mark Zuckerberg’s backroom business model has become the front door of the Facebook experience.

This is relevant. An ability to spot fake news depends on an understanding of the social media business model.

How does Mark Zuckerberg Make Money?

Mark, along with Google and every other social media, search or regular media platform makes money on ads. The more ads you see, the more money Mark and friends make. …


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Defining the terms “patient” and “consumer” will get us started here and also provide the insight and common understanding we need to tackle this seemingly elusive question.

Defining the Terms

Patient /ˈpāSHənt/

  1. adjective: able to accept or tolerate delays, problems, or suffering without becoming annoyed or anxious.
    Synonyms: forbearing, uncomplaining, tolerant, long-suffering, resigned, stoical.
  2. noun: a person receiving or registered to receive medical treatment.
    Synonyms: sick person, case, sufferer, victim.

I’ll get to the #1 (adjective) definition of “patient” soon enough don’t you worry, but to start, let’s consider #2 (noun) for about T minus five seconds. …


Two years ago, I listened to Eric Rosow, CEO of Diameter Health, pitch at an event. Basically I had one thought:

  • Diameter Health was on to something.

Plus, I just liked Eric during the brief exchange I had with him at the conference. I invited him to come on the Relentless Health Value podcast. It was partly a business decision — generally the leaders of companies that are on to something do well for the show stats-wise.

But I also have a passion for helping passionate and smart entrepreneurs clearly get their message across. Usually this means me deciding in advance what I think the narrative should be, stacking the right questions in the right order, and then wielding the post-production edit key like a weapon of mass destruction. …


…And why I strongly oppose their opposition.

Surprise billing from hospitals, in case you are unaware, is a common reason that smart, sensible and financially sound people in the United States go bankrupt.

One example is John Stockman, who went to the Emergency Room in the middle of a heart attack. He left with a bill for a million dollars, despite having decent insurance. John Stockman is not alone. 54% of Americans say they received a medical bill in the last year for care they thought was covered by their health plan. A staggering 1 in 7 in-network hospital admissions results in a surprise bill.

Surprise billing happens when an ambulance takes you to the closest hospital which just happens to be out-of-network. It happens when you triple check your surgery is covered and then find out, after receiving a bill for more money than you have in your savings account, that the anesthesiologist was out of network. It happens when your regular doctor does a blood test in his office and you get a bill for $531.71 fully one year after your visit. Like I did this…


Short answer: Pick the right hospital. Use this essential checklist to help.

The differences in the care you receive at different hospitals can be shocking. Do not underestimate the importance of choosing the right hospital if you want to stay safe and find the fastest path back to health.

Two patients walk into two different hospitals. Each has an identical cancerous tumor in their abdomen.

The first patient goes to a hospital that is a center of excellence for cancer, as designated by the National Cancer Institute. This patient has laparoscopic surgery after a tumor board of multi-disciplinary physicians agrees it’s the best approach. During the surgery, something unexpected happens, but the surgical team has done so many of this type of surgery that the nurse hands the doctor the tool she needs even before she asks. The surgery goes off with out a hitch. …


This post directly addresses one conversation only — the podcast where Ezra Klein and Sam Harris aired their respective points of view on the subject of Charles Murray, including Murray’s earlier interview with Harris and Vox’s subsequent response.

The backstory: The whole brouhaha started when Sam Harris invited Charles Murray onto his podcast to discuss Murray’s research. The research asserts among other things that there are inherited racial differences in intelligence and black Americans don’t fare as well in the IQ genetics game. Subsequently, the team at Vox where Ezra Klein was Editor in Chief wrote an article in vitriolic opposition. …


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More often than ever before, we hear our Pharma clients discussing hooking up with a technology companies, from digital health start-up to players like Amazon, IBM, Google, Apple or any of the other obvious and usual suspects. You’ve probably seen more than a few articles written about the prospect of Pharma using the capability of these innovators to collaborate with large provider organizations and payers.

Sometimes it’s clear that these articles are authored by people who haven’t actually been involved in such an arrangement. When I run across one of these, I chuckle at the delta between the rose-colored version and the no-filter version, but at a minimum I can say that collaboration is the future, and Pharma, just as much as any other stakeholder, would be well served get good at it. …

About

stacey richter

Stacey is host of the Relentless Health Value podcast and co-president of Aventria Health Group.

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