In 2009, patient-monitoring products accounted for 64 percent of the healthcare handheld market share totaling $5.3 billion.
PDAs, smart phones, tablet PCs and inventory/medication scanners — generated the other 36 percent equaling $3 billion.

Two-thirds of Physicians Use a Smartphone

Two out of three U.S. physicians use a smartphone according to an April 2010 report published by the California HealthCare Foundation. Manhattan Research forecasts that this trend among physicians will spike from 64 percent in 2009 to 81 percent in 2012.

Agile. Easy-to-use. Fast. Fun. Hand-held. Low-cost. Mobile. All stellar attributes of an on-the-go device revolutionizing how physicians practice medicine. Tap. Tap. Tap. Now at the point-of-care, doctors can access medical digital libraries, receive a patient’s lab results, confirm drug dosages, obtain CME credit, boost productivity and save time.

Medical schools are breeding a new generation of M.D.s. Georgetown, Ohio State University, and the University of Louisville require medical students to use a smartphone. These digital natives will reach for their smartphones before their stethoscopes.

Today two ecosystems, health and technology, are intersecting at a clip rate that will transform how doctors care for patients. We can expect that what is in store will make our pulse race.

After a year and a half of intensive media attention surrounding healthcare reform initiatives, Americans are still ill informed when it comes to a healthcare system that costs more than $2.5 trillion a year. I’m a firm believer, when we know more, we can make better decisions for ourselves, our families, and our employees. Here are a few basics:

Why buy health insurance?
Financial security. Health insurance protects individuals and families from unpredictable and expensive health care costs. Hospital, physician office fees, lab and diagnostic testing costs and purchasing prescription medication can mean thousands of dollars in medical bills. With health insurance, a person dramatically reduces his or her direct costs for medical care by shifting the risk to a health insurance company. The health insurance company collects a monthly premium in exchange for the peace of mind and financial protection it offers.

What are the major types of health insurance?
1. Employer-sponsored
This is the most common type of health insurance. Employers contract with various health insurance companies then pay monthly premiums for each of their employees. Workers may be required to pay a portion of the premium costs along with out-of-pocket costs including deductibles, co-payments, and co-insurance.

2. Group
Small business owners, individuals who belong to professional or trade organizations purchase health insurance through their affiliation in the group. Often the costs of the premiums and out-of-pocket costs are less expensive than if the he or she purchased health insurance as an individual.

3. Individual
When a person is not covered by an employer-sponsored health insurance program or a group, he or she may contract directly with a health plan. In this instance, the insured pays all of the premium costs and out-of-pocket fees.

4. Government
Taxpayer finance government insurance programs I call the 3Ms: Medicare, Medicaid and Military healthcare programs. The government in turn often transfers the accountability of administering these programs through contracts with for-profit and non-profit healthcare organizations.

Moving forward as taxpayers and healthcare consumers, we need to seek to be informed consumers if we hope to turnaround health care costs now.

U.S. President Obama organized this bipartisan board called the Commission on Fiscal Responsibility and Reform by executive order issued in February 2010. The U.S. President handpicked former White House Chief of Staff Erskine Bowles and former Republican Senate Whip Alan Simpson to co-chair the commission and added, “for far too long, Washington has avoided the tough choices necessary to solve our fiscal problems – and they won’t be solved overnight. But under the leadership of Erksine and Alan, I’m confident that the Commission I’m establishing today will build a bipartisan consensus to put America on the path toward fiscal reform and responsibility. I know they’ll take up their work with the sense of integrity and strength of commitment that America’s people deserve and America’s future demands.”

Today, President Obama stated, “Each year, more tax dollars are devoted to Medicare and to Medicaid.” President Obama pointed to the fact that when he entered the White House as President, the national deficit perched at $1.3 trillion dollars with a 10 year deficit projection circling $8 trillion dollars.

“But what also made these large deficits possible was that, for years, folks in Washington deferred politically difficult decisions and avoided telling hard truths about the nature of the problem,” remarked President Obama. “The fact is, it’s always easier, when you’re in public life, to share the good news -– to tell people want they want to hear instead of what they need to know.”

The Democrats and Republicans will select 3 members from each chamber for a total of 12 lawmakers. President Obama will select 6 members. Of the 6, no more than 4 may be from the same party.

Fourteen members of the commission must approve all recommendations and proposals before they are reported to Congress. The commission recommendations are due to Congress by December 2010.

In 2001, TriCare medical costs tallied $19 billion. Pentagon officials now project that in 2011, the U.S. will spend $50.7 billion in TriCare costs. That’s a 167 percent increase. Military health care costs are escalating at a clip rate. The U.S. health care spending trend pegged at an 84 percent increase, was only half of the military health care costs for the same period.

Like other taxpayer funded health programs including Medicare and Medicaid, with Tricare, the Federal government contracts with private health plans. In turn, these health insurance companies contract with civilian physicians, hospitals, psychiatrists and other health care providers to treat soldiers and their families.

TriCare costs comprise 9 percent of all defense spending, an increase of 3 percent and climbing. While testifying before Congress in February 2010, Defense Secretary Robert Gates stated that the surging upward trend of military health care costs is “beginning to eat us alive.”

Since 9/11, 1.7 million U.S. soldiers have served in Afghanistan and Iraq. The brisk tempo of repeated deployements coupled with compressed downtime between deployments, have stressed the physical and mental health of U.S. troops. The mental auguish of combat is at an all time high. One in three soliders are diagnosed with some type of mental health or behavioral health condition when he or she return from the combat zone. Post Traumatic Stress Disorder (PTSD) and Traumatic Brain Injury (TBI) are two of the signature war wounds of Operation Enduring Freedom and Operation Iraqi Freedom.

Since 2004, behavioral health counseling sessions for soldiers and their families have increased by 65 percent. Children of soldiers are at greater risk for mental health problems resulting from repeated deployments. In addtion, studies now reveal that there are significant adjustment challenges for children when a parent returns home as well. Mental health counseling sessions for children are on the rise by 42 percent.

Orthopedic wounds are the top physical medical condition for returning soldiers. Injuries to the legs, back, and joints are now common place. In 2009, there were 3.9 million health care visits to a physician or clinic because of these types of physical wounds. A related phenomenon to orthopedic injuries is the associated dependence of soldiers to pain medications. A record number of soldiers are now addicted to these prescription drugs.

The raw reality of a decade of combat is that a new generation of soldiers will continue to require Federal fiscal spending at an unprecedented rate. We can expect that military health care costs will outspend overall health care outlays both near term and long term unless significant policy, program, and process changes interrupt this trend.

In the health care industry, the dirty words are “cost-shifting”. You don’t get what you pay for. With health care, you pay for what others get. Because of cost-shifting, you end up paying for the health care costs incurred by other people.

In the U.S., five percent of Americans consume nearly 50 percent of the $2.5 trillion dollars spent on health care annually. One percent of the population consume 20 percent of all costs. In contrast, 50 percent of the population are responsible for only 3 percent of all health care expenditures. It’s this 50 percent group who spend the least who can expect premium costs to escalate.

Physicians, hospitals, and other healthcare providers are paid different amounts for the same service. What determines the amount is who the payor is. Who pays the bill? To illustrate, a doctor sees three patients for a 15-minute visit each. After the patient leaves, her office manager submits a claim for each of the patients to their insurance companies. Weeks later, the physician receives three checks. One payment is $120. A second payment is $80. Finally, the third payment is received. To the physicians shock and dismay, the payment is $45. In this example, the $45 dollar payment is from Medicaid.

With the new health care law, beginning 2014 millions of individuals will qualify for Medicaid. Estimates forecast that Medicaid rolls will swell by 30 percent, adding 16 million more Medicaid insured patients to a health care system on life support. As a result, we can anticipate more cost-shifting. More cost-shifting translates to higher premiums for employers, small business owners, and workers. Now those are certainly dirty words.

The pace and tempo of two wars in Afghanistan and Iraq continues to impact contemporary veterans, their families and our society in ways not yet fully understood. What we do know is that more and more veterans of Operation Enduring Freedom and Operation Iraqi Freedom, return home with war wounds like Traumatic Brain Injury (TBI) and Post Traumatic Stress Disorder (PTSD). Some are self-medicating pain medicines, binge drinking and abusing illegal drugs then getting into trouble with the law.

Although various Federal programs are in place to aid troubled soldiers, many do not seek this help. Even fewer, complete their course of treatments to full recovery.

Hawaii judges have reported a spike in domestic violence, altercations, high-speed driving, DUIs and drug offences involving veterans of Iraq and Afghanistan. In many cases, the offenses occur soon after the soldier returns home from combat.

On April 6, 2010, U.S. Veterans Affairs Secretary, Eric K. Shinseki, visited the first Veterans Court established in the U.S. in 2008 in Buffalo, New York to see how the hybrid treatment court model specifically for veterans can be duplicated in other communities as a viable solution to meet the needs of a country at war.

Hawaii House Judiciary Committee Discuss Veterans Court Resolution Before Issuing Approval Vote

In Hawaii, the savings of rehabilitation instead of incarceration is more than $50,000 per person per year. If 50 veterans are intercepted through a Veterans Court and are diverted from incarceration to treatment, the State will save $2.5 million annually. Significant costs savings will accrue because Federal dollars will pay for 75 percent of the court costs and 100 percent of the treatment costs. In addition, one in three homeless adults is a veteran. The Veterans Court is a critical intervention to identify and assist individuals who are at high risk for becoming homeless.

HR200 and HCR278 represents a shared commitment to solve a formidable problem and is smart, visionary public policy. Establishing a Veterans Court now is a first step to mitigate the ill effects of war on our society for generations to come.

In the same poll, 65 percent of participants revealed that they believe that the new healthcare reform law expands government’s role too much. In addition, 58 percent think that the new legislation fails to sufficiently curb costs from rising steadily.

The price tag for the new healthcare law is $940 billion over the next decade.

In my opinion, the total economic impact of the new law is significantly underestimated. Expanding government financed healthcare to 32 million uninsured Americans comes with a tremendous cost. Is this a cost the U.S. can bear? That remains to be seen.

Two days ago, President Obama signed a “middle-of-the-road”, as he describes it, health insurance reform bill into law. “This is your victory,” the President praised the Iowa crowd. “Today because of what you did that (America’s) future looks brighter and stronger than it has in some time, because of you. Three years ago we made a promise. We have kept that promise.”

“No need to shout,” President Obama remarked to a man who expressed his vehement distrust of the new healthcare law. Consistently, public polls indicate that the this man’s opinion is shared by the majority of Americans.

The President conceded that it will take four years to implement all of the reform initiatives outlined in the new healthcare law. He pointed to one policy change that will be effective this year. For small business owners, the Federal government will pay up to 35% of the cost to cover employees with health insurance through a tax credit. “Maybe they can use those savings to create jobs,” commented President Obama. Speaking about the recently enacted healthcare law, “It’s pro-jobs, pro-business and its starting this year because of you.”

Heated opposition is colliding along party lines. “Leaders of the Republican party called the passage of this bill, ‘Armageddon.’ So after I signed the bill I looked around. I didn’t see any cracks in the earth. It was a nice day,” mocked the President.

Later the President warned, “We still face enormous challenges. We will face more doubt. Some say we are reaching too far, too fast. We need to respond to the creed, ‘yes, we can’.” Then to punctuate his message, the President added, “and for you in Iowa, ‘yes, we did’ because of you.”

Iowa City proved to be a congenial place for President Obama to practice his healthcare sales pitch. As other cities open their doors to his healthcare knock, his reception may be a dramatic contrast to today.

Democrat lawmakers in the room were giddy with exuberance as they chanted, “Fired up,” then echoed in chorus, “Ready to go!”

“Today after almost a century of trying,” began the President. “Health insurance reform has come to America.”

“People who love this country can change it,” stated President Obama.

“Today, I’m signing this reform bill into law on behalf of my mother, who argued with insurance companies even as she battled cancer in her final days,” revealed the President.

President Obama took pen to paper, twenty times, to stroke his signature on the new law. Speaker of the House, Nancy Pelosi and Senate Majority Leader, Harry Reid flanked the President. Rep. Dingo, Vicky Kennedy, widow of Senator Kennedy, and a few healthcare consumers whose stories illustrate the benefit of the health insurance reform policies enacted through this new law, stood shoulder to shoulder behind the President.

President Obama cautioned, “We need to implement this bill responsibly. We need to get this right.” Beginning today, that promise will be tested most importantly by the American people who want a transformed healthcare system, but who believe the new law falls short of that aspiration and comes at too high a cost.