Regardless of your position on the new health care law, its success will depend on whether government, employers, the professions, and IT can combine to create a wellness revolution.
The stimulus funded that revolution. The reform bill merely raises the stakes for it.
The aim of the $19.2 billion in HITECH money, and the whole effort of the health IT industry, is to give people the data they need to stay well, along with the coaching they need to make use of it and change habits.
The approach has had results. Duke University cut its expected costs $30 million within a few years through a program of personalized medicine and wellness coaching. Patients were happier, too.
Corporations are now getting behind this approach. They were the buy-side of the health care equation before reform, and they still are after reform. They want to save money, and now they have incentives and tools, says PriceWaterhouseCoopers.
The problem, as former Duke Chancellor Ralph Snyderman (now with Proventys) explained to me, is that sellers of services -- hospitals, clinics, drug companies, device providers -- have no incentive to support this approach. It costs them money.
It works even better if everyone is in the pool, he added. Health costs should look like a bathtub, as Mark Kajdos of Pragmate explained. They never fall to zero, they peak at the start and end of life. Under health reform reimbursement systems should reflect this.
Support for this approach was tucked into the health care law. The FDA gets more authority, everybody gets an annual check-up, chain restaurants must post calorie counts and (perhaps most important) employers can save 30% on your insurance cost by sponsoring wellness programs.
Opponents of reform called this Big Brother and Big Government, but there's another term for it no one has mentioned, anywhere in the long drawn-out debate.
Eat your carrots. Stop smoking. Get some exercise. Stop the binge drinking. Sit up straight. Find someone nice. Sound familiar?
Every piece of advice in the wellness revolution corresponds to what your mother told you growing up and what, if you're lucky, she's still telling you.
What has changed is you will now have the data your own mother does, your employer has financial incentives to push you toward change, and access to services is now guaranteed to everyone.
Big Brother? Uh-uh. Health care reform is Big Mother.
Author's Note: A thumbnail of the illustration originally used with this post, Chris Buzelli's "Big Mother," has been removed after a complaint by its original author. I felt I was using the illustration in question under the fair use provisions of U.S. copyright law. (Further reading and analysis here.) In response to the string of comments below, I wrote about the subject in a post at Thinking Tech today. I would like to personally apologize to all who were offended by my actions or words.