Our Future: Moving Back Home?

Give or take a few years, the Millennial generation is roughly composed of those born between 1980-2000.  We number over 80 million (yes, that’s more than the number of Baby Boomers).

The eldest of this generation are starting to become parents.  Parents of Millennials are nearing retirement.

Explore this: in 15 years, the oldest Millennials will turn 43.  If they had children at 30, their oldest will turn 13.  The parents of those Millennials will largely be retired.

What’s the big deal?

From The Wall Street Journal’s Real Time Economics blog:

The study, by the McKinsey Global Institute, the think-tank arm of the consultants McKinsey and Co., carefully examined the saving behavior of various generations. The “silent” generation, the 52 million Americans born from 1925 to 1944, followed the classic pattern closely, with their household savings rate rising from below 15% in their early 20s to about 30% in their late 40s. But that pattern is almost absent for early boomers, those born 1945 to 1954; their saving rate tops out about 20%; and it’s completely absent for late boomers, those born 1955 to 1964, whose saving rate so far has remained stuck at around 10%.

Combine that with this troubling story from LifeWire via CNN:

When Stephen Leach gave up his Rockaway, New Jersey, condo at age 48 to move back in with Mom and Dad, it was out of need — his parents’, not his.

With his father suffering the ravages of Alzheimer’s disease and his mother struggling to remain in the large Randolph, New Jersey, home in which they raised five children, Leach stepped in a year ago to stabilize matters.


Such arrangements are becoming more prevalent as the population ages. An estimated 10 million American adults need help with daily activities, and family members are responsible for 80 percent of such caregiving, according to the AARP.

If the people who supposedly saved enough are having trouble paying for health care in retirement, what lies in store for the Baby Boomers who most assuredly have not?  What are the implications for their Millennial children who may incur the burden of taking care of both their parents and children simultaneously?

Expensive health care has ramifications (see above) far outside its sheer cost.  But money has the most prescient impact.  Our health care spending becomes more difficult to sustain every day.  It is expected (pdf) that there will be 2.9 workers for every Medicare beneficiary by 2020, down from 3.9 in 2003.

A sustainable health care future is desirable for all.  Eighty (plus) million Millennials will think along the same line.  The last thing we need is a parents vs. children struggle for government dollars.  Expensive health care could ignite just such a fight.

What we need are prairie dogs…

Dr. Richard Reece on vertical vs. lateral health care thinkers (via Kevin MD):

Vertical thinkers dig deeper and deeper holes across the health care landscape. At the bottom of each hole, you will find a world class expert. The only problem is the various vertical holes don’t connect. One specialist may not know what the other specialist is doing and may have no means of communicating with him/her colleagues or hospitals.

The lateral thinker, on other hand, roams the countryside looking for connections, seeking ways to put things together into an integrated whole, searching for a system blending relationships and eliminating care gaps, and hunting for self-organizing information platforms and disruptive innovations that lower costs and that work outside traditional specialty silos.

Read his very interesting (and spot-on) post.  It’s amazing how many of our problems we could solve with a proper focus on primary care.

They’re talking about you

Who is in charge of your hospital’s online reputation?  Oh, no one?

It’s increasingly important and becoming difficult to ignore.  BlogsTwitterEtc.

It need not be a full time position (yet).  Preferably it be someone who has used the technology before.

And you really should start strategizing for sites like this, this, this.  P.S. There are more and use will only increase.

People may be talking about your hospital online.  That’s good.  Especially when you can participate in (or even lead) the conversation.  They may not be talking about your hospital online.  That could be good, too.  Regardless, you have the ability to know what they’re talking about—and take appropriate action.

UPDATE: Read this story.  Decide upon appropriate action after finding your hospital here.

What’s a mistake?

More payers are ending payments to hospitals that result because of mistakes.  Makes intuitive sense.  Turns out, however, that defining mistakes is a rather gray exercise.

But the California Department of Public Health may be ushering in a new trend: fining hospitals for making mistakes.

Forecast: increasingly gray.  Issuing fines for “mistakes” is making the distinction between mistake and intentional harm more difficult to define.  Stay tuned.

UPDATE: a comprehensive list can be found here.

Going solo, international influence

Another story of a frustrated primary care physician forced to experiment with the trials and tribulations of going solo.

This doctor’s decision was driven, in part, by a sabbatical in Sweden.  Imagine these requirements in American medicine:

The Swedish doctors were equally worried about his American ways. The clinic chief swiftly laid down the rules. Oldenburg was to take a half-hour morning coffee break, like everyone else, and then a lunch break from noon to 1 p.m. and another half-hour afternoon coffee break. During these breaks, he was to socialize with his co-workers, including lab and cleaning staff, and there was to be no shop talk.

I know, I can’t either.

Health care as a campaign issue

A terrific article in The Boston Globe over the weekend on health care as a campaign issue:

Healthcare is the sharp end of the stick of nearly every issue in the presidential campaign. And it has been for almost two decades.

Much of the health care debate focuses on the uninsured.  But increasingly the insured are having issues as well:

But what of the people who are insured, the ones who are trying to navigate through the red tape and the bureaucracy, the ones who fill out the forms and check all the boxes and scope out which providers are covered under which plans, the people whom the healthcare wonks call “the worried well”? For many of them, healthcare also means gasoline as well as pills, a T schedule as well as a prescription.

Widespread transformation efforts will begin when the majority of people in this country begin to realize that their health care system is on shaky ground.  Until then it’s a macro problem affecting everyone else.