Pay for...Health??

Is it ethical to pay patients to improve their health?

We've heard of pay-for-performance, in which doctors are paid based on the clinical outcomes of their patients. P4P assumes that while doctors are motivated by seeing sick patients become better, they are also motivated financially and will perform procedures simply for financial gain.

But should we pay patients to take care of their health? Under healthcare reform, 32M patients will be enrolled in the system. Insurance companies can not deny coverage no matter how unprofitable these patients are. Therefore, it's in everyone's best interest for these patients to get better. However, many patients take poor care of themselves by eating unhealthy foods, not exercising, not taking their medications, etc. This increases their utilization of expensive healthcare services, and causes premiums of other members to rise to cover the healthcare costs of the unhealthy patients. Therefore, if we can incentivize these patients using money, we may lower the costs of the healthcare system for everyone.

I struggle with this issue because I believe people should be motivated to take care of their own health for their own sake. If they need to be paid to improve their health, are they really worth saving?

Do the ends justify the means?

Hawaii

Last month, I went to Hawaii for Spring Break with my dad. Despite growing up in California, just 5 hours away, this was my first time to Hawaii. We spent 3 days on Oahu and 2 days on Maui. In Oahu, I met a friend for dinner, visited Pearl Harbor, took a city tour, went surfing, went scuba diving to a plane wreck, and hiked up Diamond Head. I enjoyed Oahu / Honolulu and its throngs of people. In contrast, Maui was sedate. Still, it had some beautiful scenery especially at Honolua Bay where I watched advanced surfers and on the Road to Hanna. But without a doubt, the highlight of the entire trip was surfing. I had been surfing a few times, but could only occasionally get up on the board. This time, I took a lesson, and it made a huge difference. When you learn to surf in the place where surfing began, good things can happen!

Pictures:

http://picasaweb.google.com/lh/sredir?uname=Ravi913&target=ALBUM&id=5460777726156530001&authkey=Gv1sRgCKCA8Nmk_sXMKg&feat=email

Scuba Diving:

http://picasaweb.google.com/lh/sredir?uname=Ravi913&target=ALBUM&id=5460778623584763761&authkey=Gv1sRgCKDq_6fJu5X-BA&feat=email

Smartphone Decisions

I have traditionally been a late adopter of technology, especially when it comes to phones. Now I'm realizing that I want and need a smartphone. My free Nokia phone has done well for its price ($0), but I just can't keep pace with the smartphone crowd. I am seriously considering 3 phones right now:

iphone:

This is the safe choice. It's proven and its strengths and weaknesses are known. The negatives are that AT&T doesn't have a great network and that one can't multi-task on the iphone.

Droid:

Droid runs with Verizon and has a Google operating system (the Android) to support it. On the downside, it's heavy.

Nexus One:

I'm leaning towards this phone, because it seems like a cross between the Iphone and the Droid. Unfortunately, it's not yet out for Verizon. It also doesn't have as many apps as iphone, but I'm not sure how important that is.

This link has a good comparison of nexus one vs. the iphone:

http://www.ifixit.com/Misc/nexus_vs_iphone.html

I think there is no right decision here, and I'll have to take the plunge at some point.