Another idea (M-health) that need to pick up steam

[RV Pundit]

This is a private company initiative. They've done their homework and are  working with their own projections.

Secondly there is no better way to know if something will work or not apart from trying it.

Thirdly and most importantly...this system is leveraging exciting tech...m-shwari customer buy 1 yr medical insurance -cheaply -micro-insurance (CHECK) using M-pesa (as always CHECK) and that allows them the ability to call any contracted doctor any time anywhere....sort of customer care...for 1yr.

That is WONDERFUL news.

[mya88]

This is a private company initiative. They've done their homework and are  working with their own projections.

Secondly there is no better way to know if something will work or not apart from trying it.

Thirdly and most importantly...this system is leveraging exciting tech...m-shwari customer buy 1 yr medical insurance -cheaply -micro-insurance (CHECK) using M-pesa (as always CHECK) and that allows them the ability to call any contracted doctor any time anywhere....sort of customer care...for 1yr.

That is WONDERFUL news.

Again, a private company's initiative....their aim is profit making.....who is keeping them in check to make sure they actually deliver what they say?

Who is to say there are actual doctors on standby to call Pts within the hour...in a country with a pt:dr ratio of 1:100,000. Where do all these doctors all of a sudden come from?

Who is really behind the screen? How well are they versed on matters health? Who is accountable for errors made? Try they must, I only advice caution.

[MOON Ki]

Thirdly and most importantly...this system is leveraging exciting tech...m-shwari customer buy 1 yr medical insurance -cheaply -micro-insurance (CHECK) using M-pesa (as always CHECK) and that allows them the ability to call any contracted doctor any time anywhere....sort of customer care...for 1yr.

This is not correct.   They make it clear that there will be a doctor  (or doctors) "on call" at any given time, and that is who the "clients" will talk to; they will not have the ability to arbitrarily call any of the doctors.

[RV Pundit]

Semantics.I said exactly the same thing. If I am in Turkana or Mandera and I have paid for this medical cover; then I can call a doctor anytime;

This is not correct.   They make it clear that there will be a doctor  (or doctors) "on call" at any given time, and that is who the "clients" will talk to; they will not have the ability to arbitrarily call any of the doctors.

[RV Pundit]

I have no idea where they'll get extra doctors; but I know most of our doctors are not being fully utilized due to many reasons; and if somebody is paying them top dollar to receive calls; this is great news; as for regulation; how does the medium of contact; change the regulations? the doctor is licensed and knows the rules; whether they meet the pt face to face or via gmail chat room.

Again, a private company's initiative....their aim is profit making.....who is keeping them in check to make sure they actually deliver what they say?

Who is to say there are actual doctors on standby to call Pts within the hour...in a country with a pt:dr ratio of 1:100,000. Where do all these doctors all of a sudden come from?

Who is really behind the screen? How well are they versed on matters health? Who is accountable for errors made? Try they must, I only advice caution.

[MOON Ki]

The Hello DoctorHello/Sema Doctor sort of stuff has been going on in the USA for 10+ years, and what we have here appears to be just a low-end, less-thought-out version of  Teladoc:

http://www.teladoc.com/

There is a great deal to be learned from that business, including lessons on what such a system can be good for and how good it can be, lessons on regulation, etc

[mya88]

The Hello DoctorHello/Sema Doctor sort of stuff has been going on in the USA for 10+ years, and what we have here appears to be just a low-end, less-thought-out version of  Teladoc:

http://www.teladoc.com/

There is a great deal to be learned from that business, including lessons on what such a system can be good for and how good it can be, lessons on regulation, etc

That list is quite telling...jet lag is now a medical condition requiring that you contact the e-docs. Most other things such as thrush, diabetes, asthma, cholesterol and thyroid are complex diseases that require a face to face evaluation with an MD and strict follow-up. The app can be used by the treating MD's to check progress. Not sure a stranger behind the screen without the Pt's history can be able to offer much help. But lemme not rain on anyone's parade.....we shall see.

[veritas]

Medico is insurance. The underwriters are insurance companies and not taxpayers. Just because it's a govt handout, doesn't mean it means veterans receive universal healthcare benefits. They get benefits because they served in the army and army and civilian are two different populations in the USA. Anyone in the military get benefits for everything. They have their own army hospitals and I've been to veteran army hospitals and their health policies are completely different to civilian hospitals because they are/were in the army and not because they're entitled to universal healthcare. Same goes with pensioners because they're pensioners and not because of universal healthcare. Universal healthcare doesn't discriminate based of age or profession.

Health economics adhere to a capitalist model not communism. Communist healthcare systems like in Cuba don't leave healthcare systems to market forces. In capitalist countries they do. For instance, medical premiums can change for insurance companies and drug subsidies alter according to the stock market.

Please also read a politics 101 textbook- the difference between capitalism and communism.

A mark of 65 in Australia is equivalent to 75 in USA. It's common to hear of an average student in Oz transferring or studying at an Ivy League institution in the states. Having studied in the states I can say with certainty the syllabus level is way below. Failing students at a certain rate is policy in Oz. 50% for first year students etc. international students fare better because universities need their money. I suggest you check the Hansard records.

Hospitals don't have a duty of care to treat uninsured pts or  a health commissioner to investigate negligence in the USA. All treatments must be paid for by insurance companies or individuals. Taxpayers don't pay for your health. In Oz taxpayers pay insurance companies or hospitals to treat you for free.

In US they charge the pt the full cost of healthcare or the insurance company the full cost. Doctors and hospitals charge whatever they want

3. In the US specialized medicine is expensive and can cost quite a bit, that is the same in most of those other countries, (but not quite as expensive as the US) but the basic fundamental internal medicine or family practice is relatively the same. Hospitals depend on the governments Medicare/Medicaid programs and cannot just charge patients' just what they want. Fees are set in collaboration with the government and private insurance companies.

4.   In the US if you are rushed to the hospital sick, they must treat you no matter what, whether you have health insurance or not. They will have to sort out who pays what later and it can be quite costly if you do not have health insurance. The government however reimburses most of the costs incurred by the uninsured. All hospitals have to abide by this rule otherwise they will not get federal money, which to a large extent they depend on.

5.   The argument can be made, about whether the US healthcare system is better or worse that other Westernized nations, but you cannot make the argument that the US does not have a system in place, a functioning one for that matter.

6.   The idea that common wealth countries fail students just so that the government does not pay fees is the most ridiculous I have ever heard. I think they call it socialism

They put together clinical practice guidelines for health practitioners based on evidence-based or systematic reviews- things not yet established in USA

7. This assertion is not true. Healthcare in the US is large evidence based and there practice guidelines of all forms to guide practitioners on their treatment methodologies. This are very extensive studies with level I type of evidence and meta-analysis. You just need to know where to go to find them.
8.   The argument here is based on  two opposing schools of thought between the US and these other countries. see below

The central arguments in the socialism vs. capitalism debate are about economic equality and the role of government. Socialists believe economic inequality is bad for society, and the government is responsible for reducing it via programs that benefit the poor (e.g., free public education, free or subsidized healthcare, social security for the elderly, higher taxes on the rich).
On the other hand, capitalists believe that the government does not use economic resources as efficiently as private enterprises do, and therefore society is better off with the free market determining economic winners and losers.

The U.S. is widely considered the bastion of capitalism, and large parts of Scandinavia and Western Europe are considered socialist democracies. However, the truth is every developed country has some programs that are socialist.

This sums it up pretty well.

[MOON Ki]

Who is to say there are actual doctors on standby to call Pts within the hour...in a country with a pt:dr ratio of 1:100,000. Where do all these doctors all of a sudden come from?

The numbers certainly suggest that any scaling of this will be limited, and at 60 shillings for a chat and 20 shillings  for text large numbers would be required.    The other thing is that even if the doctors were there, it would not necessarily save on "doctor's time", as some of the proponents believe: 15 minutes is 15 minutes, whether in person or on the phone.

Who is really behind the screen? How well are they versed on matters health?

The significance of this point---and it is of the utmost importance---does not appear to be well understood.   

Who is accountable for errors made?

Looking at Hello/Sema Doctor's "legal agreements", it's hard to imagine anyone working harder to avoid taking responsibility for anything.  That probably helps with the tinker-toy insurance they offer, but whether the "clients" will actually go through all that stuff and appreciate its implications is another matter.

[veritas]

Political models like capitalism, communism, socialism depends on which framework for interpretation. One may identify themselves as a lenin-marxist, liberal democrat, constructivist etc. A lenin-marxist may pitch class differences as defining the types of political models I.e. capitalism enshrines status whereas communism values a classless system. A liberal democrat may pitch capitalism upholding freedom whereas communism upholds equality. One needs to identify with a framework and perspective before trying to interpret the healthcare system in a political matter.

As my favourite lecturer used to say, one needs to find the right operating system to make a computer work. A linux person won't see the same as an APPLE person. Power is not about one uniform perspective. That's not what the great game is about.

[Kim Jong-Un's Pajama Pants]

Medico is insurance. The underwriters are insurance companies and not taxpayers. Just because it's a govt handout, doesn't mean it means veterans receive universal healthcare benefits. They get benefits because they served in the army and army and civilian are two different populations in the USA. Anyone in the military get benefits for everything. They have their own army hospitals and I've been to veteran army hospitals and their health policies are completely different to civilian hospitals because they are/were in the army and not because they're entitled to universal healthcare. Same goes with pensioners because they're pensioners and not because of universal healthcare. Universal healthcare doesn't discriminate based of age or profession.

Health economics adhere to a capitalist model not communism. Communist healthcare systems like in Cuba don't leave healthcare systems to market forces. In capitalist countries they do. For instance, medical premiums can change for insurance companies and drug subsidies alter according to the stock market.

Please also read a politics 101 textbook- the difference between capitalism and communism.

A mark of 65 in Australia is equivalent to 75 in USA. It's common to hear of an average student in Oz transferring or studying at an Ivy League institution in the states. Having studied in the states I can say with certainty the syllabus level is way below. Failing students at a certain rate is policy in Oz. 50% for first year students etc. international students fare better because universities need their money. I suggest you check the Hansard records.

Hospitals don't have a duty of care to treat uninsured pts or  a health commissioner to investigate negligence in the USA. All treatments must be paid for by insurance companies or individuals. Taxpayers don't pay for your health. In Oz taxpayers pay insurance companies or hospitals to treat you for free.

In US they charge the pt the full cost of healthcare or the insurance company the full cost. Doctors and hospitals charge whatever they want

3. In the US specialized medicine is expensive and can cost quite a bit, that is the same in most of those other countries, (but not quite as expensive as the US) but the basic fundamental internal medicine or family practice is relatively the same. Hospitals depend on the governments Medicare/Medicaid programs and cannot just charge patients' just what they want. Fees are set in collaboration with the government and private insurance companies.

4.   In the US if you are rushed to the hospital sick, they must treat you no matter what, whether you have health insurance or not. They will have to sort out who pays what later and it can be quite costly if you do not have health insurance. The government however reimburses most of the costs incurred by the uninsured. All hospitals have to abide by this rule otherwise they will not get federal money, which to a large extent they depend on.

5.   The argument can be made, about whether the US healthcare system is better or worse that other Westernized nations, but you cannot make the argument that the US does not have a system in place, a functioning one for that matter.

6.   The idea that common wealth countries fail students just so that the government does not pay fees is the most ridiculous I have ever heard. I think they call it socialism

They put together clinical practice guidelines for health practitioners based on evidence-based or systematic reviews- things not yet established in USA

7. This assertion is not true. Healthcare in the US is large evidence based and there practice guidelines of all forms to guide practitioners on their treatment methodologies. This are very extensive studies with level I type of evidence and meta-analysis. You just need to know where to go to find them.
8.   The argument here is based on  two opposing schools of thought between the US and these other countries. see below

The central arguments in the socialism vs. capitalism debate are about economic equality and the role of government. Socialists believe economic inequality is bad for society, and the government is responsible for reducing it via programs that benefit the poor (e.g., free public education, free or subsidized healthcare, social security for the elderly, higher taxes on the rich).
On the other hand, capitalists believe that the government does not use economic resources as efficiently as private enterprises do, and therefore society is better off with the free market determining economic winners and losers.

The U.S. is widely considered the bastion of capitalism, and large parts of Scandinavia and Western Europe are considered socialist democracies. However, the truth is every developed country has some programs that are socialist.

This sums it up pretty well.

veri,

The way I understand it, in the US, Medicare is a government program, as is Medicaid.  Medicare is for old people, Medicaid is for poor people.  That is a simplification, but it is largely the purpose that these two programs serve.

So you could say that universal healthcare is not a guarantee in the states and you would be right.  Healthcare is heavily privatized. 

I am not sure about the relevance of academic scores and comparisons in the medical field.  These seem kind of besides the point to me.  Because both countries have advanced healthcare and deal with more or less the same problems effectively.  If you are qualified to practice in the US, you are definitely among the best in your field.

If you have medical cover and find yourself falling dangerously ill in the states, you should like your chances just as much as if not better than anywhere else.  But if you are not covered, you will be saved and could become bankrupt; you may also avoid necessary doctor's visits that could prevent a dangerous condition from developing because of costs.

The biggest driver of healthcare costs in the US from that I have heard is insurance companies, and biotech companies that do cutting edge research.

[MOON Ki]

The comparisons between the USA and Commonwealth countries are interesting, even if one excludes the fact that only a small handful of the latter have anything that even remotely resembles a decent healthcare system.   

My own personal observations---and, of course, these are not determinative---is that if it comes to overall quality, I'll take the US system any day.    On the other hand, when it comes to the direct payment for prescriptions, the UK, Canada, etc. may be considered to have an "advantage".   

[veritas]

Windy,

Medicaid in the United States is a social health care program for families and individuals with low income and limited resources. The Health Insurance Association of America describes Medicaid as a "government insurance program for persons of all ages whose income and resources are insufficient to pay for health care."

It's insurance. Oz has that too for pensioners and youth in the form of discounts and insurance underwriters. That's not universal healthcare.

Universal health care, sometimes referred to as universal health coverage, universal coverage, or universal care, usually refers to a health care system which provides health care and financial protection to all citizens of a particular country.

Both quotes are from Google. I'm not sure if some peeps have been drunk posting or genuinely retarded when it comes to healthcare.

[veritas]

The comparisons between the USA and Commonwealth countries are interesting, even if one excludes the fact that only a small handful of the latter have anything that even remotely resembles a decent healthcare system.   

My own personal observations---and, of course, these are not determinative---is that if it comes to overall quality, I'll take the US system any day.    On the other hand, when it comes to the direct payment for prescriptions, the UK, Canada, etc. may be considered to have an "advantage".   

Basic healthcare is considered a privilege in the States when it shouldn't be. If you can't afford health insurance you have no access to basic healthcare. I'd imagine that would include lots of able bodied college students and working households budgeting for other things. Australian doctors are boring poor compared to the exciting rich corrupt American doctor. An American doctor will promise you the world with the intention of prescribing a Big Pharma product you probably don't need. You can't just walk in there and demand this drug of this brand but you can in Oz. Also, American doctors can't churn out quality medical research nor influence the health world. On the otherhand if you have money, you can have any procedure done in the States whereas Oz has a waiting list and limited treatment options for certain conditions like cancer. If you have cancer, you need Big Pharma- move to the States.

[mya88]

Windy,

Medicaid in the United States is a social health care program for families and individuals with low income and limited resources. The Health Insurance Association of America describes Medicaid as a "government insurance program for persons of all ages whose income and resources are insufficient to pay for health care."

It's insurance. Oz has that too for pensioners and youth in the form of discounts and insurance underwriters. That's not universal healthcare.

Universal health care, sometimes referred to as universal health coverage, universal coverage, or universal care, usually refers to a health care system which provides health care and financial protection to all citizens of a particular country.

Both quotes are from Google. I'm not sure if some peeps have been drunk posting or genuinely retarded when it comes to healthcare.

From my assessment of your postings and the tendency to mix issues, you could be accused of drunk posting yourself. Since google seem to be your friend, use it more to learn about the American health system. No one here ever made the argument that it was universal yet...merely that we are leaning towards universal. And yes with all that good stuff you talk about in the common wealth, you will still have to get on the waiting list to get specialist treatment, while all I need to do is look up one, call and walah... I have an appointment for whatever procedure I needed.

http://www.hhs.gov/healthcare/rights/law/index.html

[MOON Ki]

Secondly there is no better way to know if something will work or not apart from trying it.

Indeed.   But haven't we already had a trial?

I just got some email from a friend, to the effect that Safaricom has been down this road before, with some gimmick called Daktari 1525.   That was back in 2011. That too was going to save the Kenyan healthcare system in exactly the same way as the new-and-improved is going to:

Safaricom, Kenya's largest telecoms operator, is trying to take the pressure off overstretched medical and health systems with a new mobile health service. Its 24-hour health advice and referral service is called 'Daktari 1525' and lets people call and speak with a doctor or an expert to get advice on any health issue.
...
The new service hopes to relieve outpatient departments in government hospitals and health facilities with its advice and referrals. 
...
Not everyone is convinced the service will work.

http://www.southerninnovator.org/index.php/innovation/195-new-kenyan-services-to-innovate-mobile-health-and-farming

It appears that there weren't enough suckers clients to sustain the system.   A year later, fees were halved.   Another year later and things folded quietly. 

One of the things that is different with this new scheme relates to the insurance aspect, of which you write that:

Thirdly and most importantly...this system is leveraging exciting tech...m-shwari customer buy 1 yr medical insurance -cheaply -micro-insurance (CHECK) using M-pesa (as always CHECK) and that allows them the ability to call any contracted doctor any time anywhere....sort of customer care...for 1yr.

On the face of it, this actually looks quite attractive and could well attract people to the new-and-improved.   Looking below the surface, I would note that:

* The basic insurance "element" is for KSH 5000 and that's only if a hospital stay is involved. By the time one pays the annual 300*12 KSH plus the cost of phone calls etc., I'm not sure they would be getting a great deal.   Even in Kenya, it should be possible to get insurance at a lesser cost.

* Getting that money requires hospitalization, and their list of conditions does not include many things for which Kenyans end up in hospital.  And one can also argue that the annual limit on the insurance payoff for hospitalization is up to KSH 15,000.   On that:

- The frequency with which the average person gets hospitalized is actually not very high.   Even in Kenya.   

- In the list of "acceptable conditions", Malaria and the CHRONICS could easily put one into hospital more than once.   But the "fine print" states that once you've claimed on a particular condition, you may not ever again claim on that same condition.   

- That means that in order to keep benefitting from the insurance, you must (a) be ill enough to be hospitalized on each occasion and (b) be ill from something that has not previously required hospitalization (as far as that policy is concerned).  You have to keep getting very ill from new things. 

Let's consider just one year.  So, what is the likelihood that an average person in Kenya will get hospitalized for 3 different things on this list:

And if one manages the first year, what is the probability that one can keep "finding" new things to get hospitalized on?

mya88 wrote that:

Again, a private company's initiative....their aim is profit making.....

Folks have to eat, and that frequently means making money.   Nothing wrong with that; the revolution is over and the "capitalist pigs" won.   But we should be wary when we see the same at-long-last-salvation! being peddled with the only change being a bit of spit and polish.

It could work, in the sense that the M-* folks could end up making money.   That would be great---for them and their shareholders.   But radically change the healthcare system in Kenya or have a significant effect on the health of Kenyans?   Alchemy.   We'll just have to wait and see.

[MOON Ki]

And yes with all that good stuff you talk about in the common wealth, you will still have to get on the waiting list to get specialist treatment, while all I need to do is look up one,

People sometimes overlook this when making comparisons.   In the USA if you need to (or even merely want to) see a specialist, you simply find one (Google, Yellow Pages, etc.) you think you might like, call or send email, and then off you go.   That's not possible in places like the UK: there the NHS system used to claim that they would guarantee one within 18 weeks, but that hasn't worked and all it's done is get people extremely pissed off at the long waiting times.  It looks like the government will now scrap any attempt at a guarantee and simply say "you get to see one when you get to see one".   

I also note that there are some interesting claims being made for the Australian healthcare system.  One of them is that, beyond basic taxes, everything is free for all and that doctors there (unlike greedy Americans) must charge a fixed fee.  On that:

* Australian doctors can, and quite a few do, charge whatever fee they like.   Medicare will cover only the "schedule fee", and it is up to the patient or insurance company to pay the rest.

* The Australian system actually forces many people---and deliberately so---so buy private health insurance, amidst this claimed cornucopia of freebies.   This is done via something called the Medicare Levy Surcharge.   The government basically says "we think you make enough to afford private insurance, so if you don't get it we'll tax you some more".   People look at the tax and the insurance rates, and it's called an offer one can't refuse.

Oh, the Aborigines are simply screwed, no matter what.  None of the above, or anything else applies to them.  Apparently.

[RV Pundit]

And you think folks in Turkana have no business calling a doctor?

, you simply find one (Google, Yellow Pages, etc.) you think you might like, call or send email, and then off you go.   That's not possible in places like the UK: there the NHS system used to claim that they would guarantee one within 18 weeks,

[veritas]

Windy,

Medicaid in the United States is a social health care program for families and individuals with low income and limited resources. The Health Insurance Association of America describes Medicaid as a "government insurance program for persons of all ages whose income and resources are insufficient to pay for health care."

It's insurance. Oz has that too for pensioners and youth in the form of discounts and insurance underwriters. That's not universal healthcare.

Universal health care, sometimes referred to as universal health coverage, universal coverage, or universal care, usually refers to a health care system which provides health care and financial protection to all citizens of a particular country.

Both quotes are from Google. I'm not sure if some peeps have been drunk posting or genuinely retarded when it comes to healthcare.

From my assessment of your postings and the tendency to mix issues, you could be accused of drunk posting yourself. Since google seem to be your friend, use it more to learn about the American health system. No one here ever made the argument that it was universal yet...merely that we are leaning towards universal. And yes with all that good stuff you talk about in the common wealth, you will still have to get on the waiting list to get specialist treatment, while all I need to do is look up one, call and walah... I have an appointment for whatever procedure I needed.

http://www.hhs.gov/healthcare/rights/law/index.html

The problem with you is your ego and not being able to admit you're wrong. You have a tendency to ignore facts and obviously don't possess the cognitive capacity to understand complex issues. That is why you are retarded.

[Kim Jong-Un's Pajama Pants]

veritas,

I thought we agreed to keep this kind of attitude off the site.  Are you okay? 

Since you enjoy impunity, I think you should apologize to mya88.