healthcare reform.

Dear John,

While I do not like government run institutions, there are a few things in life that the government has made our lives better while managing it.

Our government has the right to manage interstate commerce, and as I see it now, our Health System is an Interstate Commerce problem. Not only do companies have employees in several states, but people travel, move and have families dispersed all the time across our great nation. In addition, people who require help in an emergency, or people that have contracted a communicatable disease put a stress on all of us when their health care is not provided for. Either hospitals treat these people without getting paid, or they die, or worse they spread the disease to others.

As our country continues to grow to being more and more urban, we need to deal with problems as a set of communities rather than as a body of individuals.

So, in general I support a number of points of health care reform.

Early In my life I worked at a medical billing company and I know all too well how insurance companies skip out on paying bills, and how doctors inflate bills to get good payers to pick up the slack for other more dishonest insurance companies.

I urge those that are passionate about health care to help us simplify, streamline, and clean out the corruption in the healthcare industry. Our parents, and grand parents are at risk.

I propose several changes to the system.

1. provide leadership and standardize payment processing, require that health insurance companies pay 80-90% of claims. right now they pay less than half of all submitted claims.

2. provide a validation engine for said claims, such a validation engine has been built to determine if an HTML document is valid. I suspect such an engine could be built to validate a medical bill. this would validate the patients identity, the medical practitioners identity, and the payers identity. the system would also validate viable pairings of CPC codes ( medical care line items ). Items that are unusual could flag a review process by a board of medical practitioners.

3. record all bills and assemble a medical care census, and provide the data in aggregate, and autonomously to the public to crunch. with proper statistical records on care patterns people can dig into the information and get a good view on where innovation needs to occur, and where current innovation is not yet being used. right now only health insurance companies have this data, and this should be public data so others can help and map out solutions for our general well being.

4. provide leadership in sourcing funding for problems in the system that are identified through statistical methods. in some cases direct taxes might make sense to provide research funding, and in other contexts, businesses might rally together to provide said funding in a prize economics / ‘netflix prize’ sort of way. using the data from #3 we can very easily identify treatment pairs that are raising in cost and ones that need additional research done to better advance them.

5. require that insurance companies can not deny someone based on pre-existing conditions. this forces insurance companies to have a broad demographic.

6. allow young individuals some sustained benefit for purchasing health insurance at a young age and keeping it up. I think it’s silly to pay $2400 a year and visit the doctor once in 3 years. Paying straight cash for a $500 doctors visit is still cheaper. For people that invest in the system and don’t have health problems, some percentage of their payment should lead to reduced payments later in life. it should kinda be an investment vehicle, and if one pays additional dollars at a young age into the system one should get better care later in life, as health costs should always be more later in life than earlier in life.

7. build an infrastructure so that doctors can virtually review a patient together via video conferencing. reviewing patients with multiple opinions can reduce errors. In the programing space we call it extreme programing, or pair programing, and certain cases might be flagged for care that is prone to error.

3 Thoughts on “healthcare reform.

  1. Hi-

    Saw your post on HN. I just posted this on HN. Wondered if you might be interested in the concept.

    Thanks for your thoughts! – Comments, critiques and conversations would be greatly appreciated. Also looking for two wickedly smart hackers to help co-found and apply to YC10.

    Concept Idea: Help people eat better, socialize more efficiently, spend less, do more and enjoy life extensively

    SayChef! (what would you do.?.. what do you have to say?.. this is what I say!.. what do my friends say?.. ) ChefPoints and ChefRewards based on system activity. Put a market maker in food
    via your own virtual personal assistant and concierge. A new interface at the intersection between mobile, local, and urban life. This world is a game; play it.

    Think…. the personal assistant space including Siri, Aloqa and Geodelic’s Sherpa combined with the LBS game mentality space of Foursquare and Gowalla.

    There is a reason each above mentioned (& recently funded or launched) start up always mentions food and restaurants along with accompanying entertainment or shopping based activities in their descriptions.
    Its the most localized, high impact spot in the market. According to comScore, advertisements for restaurants and food boast the highest response rates of all SMS advertising. Monetize the credibility.

    SayChef!… Enhanced with technologies to improve the user experience such as speech recognition, natural language processing, semantic data processing, and geo-location to create a virtual assistant/concierge that helps you perform tasks through a simple conversational, question-and-answer interface. It already is a branded interface– use it. Create conversations– earn free food.

    Make the Internet (especially the mobile version) a far simpler tool to help you get things done. Processing intent on what someone is trying to do, where they are, who they are…. and then helping them do it.
    Make it easy to communicate through speech recognition, intent understanding, and a simple conversational interface.

    A personalized shopping assistant in food & entertainment purchasing that understands specialized needs, gps locations, digital coupons and feedback channels, creating a game mentality in food & entertainment recommendation and purchasing– segueing into shopping and travel. Combining the network effects of semantic social marketing, with personalized choices in food purchasing could in effect create a trusted curator of the kitchen, in the cloud.

    What would you say if you could talk to your computer? How would you want it to respond back?

    Action: Talk to your friend:

    SayChef?….. (what would you do? this is what I say! what do my friends say? what is everyone else doing? )

    Reaction: ChefPoints and ChefRewards for certain actions:

    ChefPoints….. to certain deals and conversations.
    ChefRewards…. based on system based activity on points earned.
    FoodPoints…. a management system for food.
    ChefCard…. a digital wallet.
    ChefPlan…. financial budgeting tool for professional and recreational chefs regarding food and entertainment spending.
    MyFoodChef…. personalized chef for eating needs, geographic, demographic & socially specific.

    If you had a personal shopping assistant in daily living, who knew everything…. wouldn’t that be cool and make life a bit more fun? Not an askjeeves. But close proximity; more like a Rosie from Jetsons. Jeeves was a butler, your personalized Chef is a friend. Chef is an interactive presence who knows all of the ‘kitchen in the cloud’, inside the house and out. Knows all appropriate activities before and after an eating occasion, knows and aggregates your likes, dislikes, and hobbies- according to importance and relevancy. Chef knows the deals at the grocery store, local restaurants, food buzz, entertainment sensations and relevant shopping necessities that occur between meal times. Pay with your mobile phone or card, creating a digital wallet…. earn points, create conversations, and make the rewards sensational.

    Adding a customizable avatar to visually represent Chef and allow users to personalize their own chefs with the avatar animations text to voice, would make a rich personalized experience. Voice recog, natural language search and query results are one aspect of the conversation. Functionally adding events to a calendar, to do lists, making status updates for you, jotting down notes- adds depth to the relationship. Add a data mesh with localized fetches from multiple sources adding social graph data as in twitter/facebook tweets/posts from your top friends that are relevant to the query, as well as reviews, suggestions and personalized recommendations.

    Semantically your Chef becomes smarter as it better understands you and can better suggest appropriate choices. Since there are 4-6 eating occurrences a day, that leaves plenty of activities to recommend, suggest, save-on, group up with, etc. GPS enable, digitally connect to, get coupon aware of, knowledgeably interfaced to, socially wired with, aggregated real-time content, and continually getting smarter, better & faster. Chef aggregates many consumer mobile experiences and associates them with locations and activities that are relevant. This will save time, money and create something people will want.

    Revenue Possibilities:
    * Market-maker: Obviously matching buyer and sellers through relevant markets could create an arbitrage situation. The foodservice, entertainment, travel and shopping markets are huge.
    * Digital Coupons: The hottest market in mobile marketing; create an avenue to organize, manage and facilitate increased coupons redemption for maximized value.
    * Social Network Effect: Talk to your friends around food and circumstances. Start conversations. Increase the amount of traffic. Tell your friends. earn points. Be fired up, tell more friends; you’re friends are doing the same. Sell & monetize advertising to them.
    * Digital Wallet/ ChefCard: Digitally branded wallet enabled by mobile commerce on individuals’ personal communications devices. Electronic or Plastic. Take a piece of each transaction.
    * CRM: Obviously after meshing the incoming/outgoing data, a large bit of information could be harvested to sell to companies looking to improve their customer service management & better manage their mobile strategy.
    * Levels: Subscription based model for people looking to upgrade their status. Different levels, different rewards. A system influenced by status and credibility. It is a game you know?

    Why this company is different: We are a marketing company looking for a combination of technology interfaces, not a technology company looking for marketing. The space is solid. The concept is unique, marketable and defensible.

    Me: Grew up in the Seattle area. Graduated from the Univ. of Arizona with a degree in Mktg, Comm & Poly Sci. Held various leadership positions through college and worked for Senator John McCain in communications and stumped speeched for him numerous times. Got entrepreneurial, moved to San Francisco and started, operated and sold a coffee company. Worked as a consultant, taught classes on how to start a coffee business, created business plans for three years and actually helped opened a few. Took some graduate classes in Marketing, Corporate Finance, and Internet Business Technology at USF and UCB. Graduated SF Renaissance Entrepreneurship Course. Worked in sales for illy caffe, Sysco Foodservice, and, all while finding reinforcement for the critical need for this product. Moved to Maui three years ago with a girl to escape the city and find a beach, a backyard and a dog. I’ll miss the weather, the surf and the dog, but I need to start this company. I enjoy eating, skiing, playing tennis, golf and backgammon. I’ve done two triathlon sprints and a few 60+ mile bike races and find myself competitive. I’m pretty easy to get along with and really want to see this company work. It’s been nine years waiting for the right timing to start this.. and its time to apply to Top Gun. I want to learn to fly jets (Internet technology companies) with the best of the best at Top Gun training (@YC) and need two wingmen/wingwomen to help fly this jet.

    What I need: Smart, intelligent people to help make the foundation of this work efficiently. Two wingmen/wingmen to help fly the jet at first and a few people on the ground as ground support and advisers.

    Especially the Co-Founders: Two stellar hackers who see the vision and have the skills to execute what this needs. One a wizard with code, who can program and CTO the project with scaling in mind architecturally.   The other a master of the pixels who can make the UI appealing, compelling and clean graphically. Be cool, calm and wicked smart.

    More Smart People: If you find yourself mildly interested in this, please just let me know any thoughts, comments or critiques. Of course this jet is going to need a few good advisers as well because this is going to attack a big space and the more incredibly smart people involved, the better. If you hate it, and think it sucks… kindly tell me that as well. Mahalo either way.

    Thanks so much for reading this and forming a thought, comment, critique or response. WAR YC10! Do something new; embrace the digital future! Further inquiry- let me know — jtrendall AT gmail DOT com.

  2. what version of the OS and browser are you using? it looks fine on mine.

  3. What I still did not understand about the Government plan is this segment about pre-existing conditions… Is there any vocabulary in this bill about wether or not there is a limitation on what insurance companies can demand if you have a pre-existing ailment?

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