When a patient is in need of blood that isn’t available, it becomes a life and death situation. Historically the Red Cross will make efforts to alert the public during a shortage. But there may be a better way – leverage the social networks to get the word out. If shortages of a certain type of blood occur in a certain zip code, having a database of willing donors in that zip code to contact may be the most efficient way to solve the problem quickly.

That’s where Takes All Types (TAT), a non-profit organization, comes in. Users install their just-released Facebook application, tell it their location and blood type, and say how often they are willing to be contacted to donate blood (maximum is every 57 days). If a shortage occurs, they’ll contact you via the methods that you authorize (Facebook, email, text message, etc.)

This is a perfect example of innovation helping to move healthcare information and services (in this case, a call on social responsibility) to where consumers already are. This furthers the trend toward placing clinics in convenient retail locations or bringing doctors where people want to be, whether at home, in the office or even to the streets of the local neighborhood.

The trends, as health becomes more of a consumer-focused culture, will be to bring care back outside the massive institutions such as the hospital and back into our own homes, with all the savings in overhead and unnecessary technology that come with a occupying a hospital bed.
Instead, lightweight technologies enabled by the internet and via telemedicine and an increasingly sophisticated doctor’s bag will bring healthcare services back into the community, specified to the level of services required by and personalized to the consumer.

On the surface, this sounds good– coverage for more children. As someone who strongly considered pediatrics as his calling, I wholeheartedly believe that better health for kids is something strongly needed– especially in an era with increasing childhood obesity, diabetes, etc. While at the LA County hospital, I cared for a number of kids with SCFE– kids so heavy that their growth plates in their hips started to slip/break from the weight being placed on them. It was heartbreaking to see young kids (12-14) who’s health was already compromised to the point that they were unlikely to live full, active lives.

One would expect that any additional funds for children’s health would be invested in creating additional programs to improve wellness, increase physical fitness, emphasize good nutritional habits, and screen for early-stage addressable illnesses.

However, this isn’t about better health for more children…this is about expanding government programs to those who don’t need them– and will likely be harmed by the change.

As John Goodman cites in his blog and WSJ editorial:

Almost eight of every 10 children whose parents earn from 200%-300% more than the poverty level already have private health-care coverage, according to the Congressional Budget office (CBO). At incomes between 300% and 400% more than poverty, nine of every 10 children are already insured.

What about the eight to nine million children currently uninsured? Nearly 75% of them are already eligible for Medicaid or Schip, according to the CBO. So the main result of the Democrats’ proposal to expand Schip will be to shift middle-class children from private to public plans.

Why is that bad? One reason is that most Schip programs pay doctors at Medicaid rates — rates so low that Medicaid patients are having increasing difficulty getting access to health care. Anecdotal evidence suggests that U.S. Medicaid patients already must wait as long for specialist care and hospital surgery as in Canada.

Many doctors won’t see Medicaid patients. Among those that do, many will not accept new patients. As a result, children who lose private coverage and enroll in Schip are likely to get less care, not more.

Instead of providing better care for kids, we’re just throwing more public money at existing, sub-optimal fee-for-procedure systems of today. And in the process, we’re likely to reduce reimbursement to pediatricians already at the bottom of the physician payscale, while asking them to do more. As I mention in previous posts, government mandates tend to accentuate rather than solve the problems they try to fix.

Driving more qualified physicians away from pediatrics through low reimbursement doesn’t seem to be the answer to improving children’s health. These aren’t the people making huge incomes…and lowering reimbursement won’t attract high quality people to medicine.

Instead, lets invest money in recess, physical education programs, and improved nutrition of school lunches– things that impact all kids and set habits for a lifetime to come.