Category Archives: Culture

Drinking while grocery shopping. Is pot next?

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Where did my grocery cart disappear to?

Amazon.com seems to be unstoppable. It’s grabbed the lion’s share of the e-commerce market, turned other retailers into mere showrooms for shoppers who then purchase online, discarded list prices in favor of its own internal comparisons, and turned Prime Day into a new national shopping holiday. Little buttons around the house can be pressed to reorder staples, and voice commands to my Amazon Echo can summon goods to the home.

Supermarkets are now in Amazon’s sights. I’ve received come-ons lately for Amazon Fresh.

But instead of quaking in their boots, some supermarkets are taking a page from the casino playbook and offering inexpensive alcoholic beverages to customers. From the Wall Street Journal (Supermarkets Invite Shoppers to Drink While They Shop):

At nearly 350 Whole Foods locations nationwide, shoppers can carry open beverages out of the bar area and around the store as they shop around. Some stores have added cup holders to their shopping carts or placed racks around the store where shoppers can place empty stemless wine glasses. In some Texas locations, the $1 cans of beer rest in ice-filled buckets labeled “walkin’ around beer.” “When customers find out that they can sip and shop, a lot of times it’s a lightbulb moment,” Mr. Kopperud says.

Take that Jeff Bezos!

As just about everyone knows, alcohol lowers inhibitions and is more or less guaranteed to boost retail sales. Impulse purchase anyone?

But let’s fast forward this story just a bit. With the movement toward the legalization of marijuana for recreational purposes –which I oppose– it’s just a matter of time before these same stores start opening marijuana boutiques at their entrances, featuring a wide variety of tasty edibles. For Whole Foods they will likely be organic, gluten free and artisanal.

You can bet the munchies will contribute to a healthy boost to the average sale!

Come to think of it, these two ideas aren’t mutually exclusive. A walkin’ around beer and a marijuana edible sounds pretty darn attractive.

Ok, Amazon. What’s your reply?

Image courtesy of iosphere at FreeDigitalPhotos.net

By healthcare business consultant David E. Williams, president of Health Business Group.

Staying away from substance abuse on campus

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Safe at home

The opioid epidemic is truly devastating. Drug overdoses (mostly opioids) are a leading cause of death in the US, topping guns and car crashes. People don’t want to become addicted to drugs or die from overdoses, so why does it happen so often?

It often starts with a doctor writing a prescription for someone complaining of chronic or acute pain or following a surgical procedure. Little thought is given to the number of pills prescribed; extra pills are either consumed by the patient or left lying around in the medicine cabinet where they may be taken by family members or house guests who have developed a habit. When prescription pills run out and the cost of buying them on the black market is too high, users shift quickly to heroin, which is cheap, potent and readily available. The downward spiral can be steep.

Thankfully, the country is starting to get a grip on the opioid crisis. Health insurers are tightening up on opioid coverage, doctors are trying alternative therapies (like massage) or being more conservative in their prescribing. TV and newspaper stories are pointing out the perils.

Awareness is spreading, including to the younger generation. I’m really pleased to see that some colleges are offering “sober dorms” for students committed to a substance-free lifestyle. The idea is not brand new –a Rutgers program dates back to 1988—but it seems to be gaining traction as more schools try out the approach.

A number of schools offer housing for people in recovery, designed to prevent relapse. New Jersey has a new law requiring any college with more than one quarter of students living on campus to offer sober housing. Other schools are starting to offer sober dorms to students who are looking for a clean lifestyle, whether they are in recovery or not.

It’s also my impression that college administrators are doing more than they used to to enforce alcohol and drug laws, regardless of a dorm’s official designation.

Image courtesy of Stuart Miles at FreeDigitalPhotos.net

By healthcare business consultant David E. Williams, president of Health Business Group.

In the future, will every job be a healthcare job?

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I’m here for your job

The US added 38,000 jobs in May, including 46,000 in healthcare. In other words, healthcare added more than 100 percent of the new jobs in the economy. That won’t happen every month, but it’s a pretty striking statistic.

What’s going on here?

I recently read The Second Machine Age: Work, Progress, and Prosperity in a Time of Brilliant Technologies, which basically argues that almost all jobs –including highly skilled ones– will be wiped out by automation, robots and artificial intelligence. Case in point: truck drivers and taxi drivers, who will be replaced by self-driving vehicles.

Job destruction is happening today on a large scale. Manual laborers have been vulnerable for a long time, but professionals are now under threat as well. There’s little opportunity in previously safe jobs like bookkeeper and paralegal. I firmly believe that a big driver of Donald Trump’s popularity is the alienation felt by many workers –including skilled ones– whom the economy no longer really needs or won’t need soon. It’s easy to blame free trade pacts, Chinese, Mexicans, and our feckless political leadership, but technology is actually the root cause.

The two big exceptions to job loss are healthcare and education, sectors that have been very slow to match the innovation pace established by the rest of the economy. That’s kept costs high and rising. As a result, Americans are getting killed by healthcare and education expenses at a time that incomes are stagnant.

Healthcare is always 10-20 years behind the rest of the economy (I’ll let someone else speak for education) so we can expect continued robust healthcare hiring for some time.

If the jobless future described in The Second Machine Age really comes to pass, society will be in serious trouble. I really don’t like the author’s idea of addressing joblessness by paying everyone a guaranteed minimum income. Sure people need an income, but they also need purpose in life, which often comes from having something productive to do on the job.

As I’ve been saying for years –for example Welcoming immigrants and robots to fill the nursing shortage and Robots are coming and they plan to treat you like a moron –I do think healthcare will eventually catch up with the rest of the economy and healthcare jobs will go by the wayside. But maybe there will be enough lag time that we will in fact preserve and invent meaningful jobs in healthcare, and that the healthcare field will lead the next wave for the re-humanization of the economy.

Image courtesy of Geerati at FreeDigitalPhotos.net

By healthcare business consultant David E. Williams, president of Health Business Group.

 

Canada is looking better and better

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O Canada!

In almost every election cycle people talk about moving to Canada if a presidential candidate they despise takes office. In practice few make the move. Things could be a little different this time around if a certain nationalist strongman comes to power.

There’s something else to fear this year: the Zika virus. According to NIH director Tony Fauci, mosquitoes with Zika are likely to arrive in the US mainland within the next month or two. One species will be all over the South, another will come up the East Coast as far as New England. Already, close to 300 pregnant women in the US are infected.

Congress is dithering with the President’s request for funds to combat Zika’s spread and is toying with the idea of canceling Ebola funds to partially support the Zika fight. It’s pretty irresponsible.

In the past I would have assumed that Congress would get it’s act together and do the right thing. But after seeing some members unconcerned about preventing a default I no longer take good intentions and common sense for granted.

Zika is serious and its spread could have a big impact on economic growth. In El Salvador, the government has advised women not to get pregnant for the next two years, lest they give birth to babies with severe birth defects. Can you imagine the impact such an advisory would have in the US?

Image courtesy of Vlado at FreeDigitalPhotos.net

By healthcare business consultant David E. Williams, president of Health Business Group.

The false link between mental illness and gun violence

It would be nice if we could eliminate mass shootings by improving the mental health system, coaxing (or forcing) potential shooters into treatment before they have a chance to wreak havoc.  As the Washington Post (Most mass shooters aren’t mentally ill. So why push better treatment as the answer?) reports:

“It would be ridiculous to hope that doing something about the mental-health system will stop these mass murders,” said Michael Stone, a forensic psychiatrist at the Columbia College of Physicians and Surgeons and author of “The Anatomy of Evil,” which examines the personalities of brutal killers. “It’s really folly.”

This seems pretty obvious, and yet Republican and Democratic leaders, along with the general public and the media seem to think mental illness is the root cause of shooting sprees and that improving the mental health system can fix the problem.

After mass shootings, reporters often jump quickly to mental illness as the cause. Remember after the Sandy Hook shooting when there was speculation that the shooter’s Asperger’s diagnosis was to blame?

Asperger’s? Are you kidding me?

The danger of our fixation on mental illness as the root cause of violence is that we end up stigmatizing people with mental illness –and developmental disorders– while ignoring more direct causes of gun violence, such as ready access to guns.

Mass shootings are rare outside the US. Is there someone who can tell me with a straight face that the difference is due to better mental health systems abroad?

Meanwhile, Australia has seen a major decrease in gun violence over the past 20 years since adopting strong gun control after a mass murder. That seems like a more evidence and logic based response than what we’ve tried here.

By healthcare business consultant David E. Williams, president of Health Business Group.

 

The decline of white women’s health

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The Washington Post (A great divide in American death: Statistics show widening urban-rural gap) examined death statistics and found that death rates for white women –especially rural white women– have been climbing fast. Key culprits? Self-destructive behavior such as over-eating, opioid abuse, heavy drinking, smoking, and suicide. White women still live longer than other groups, but the trend for them is bad.

According to the Post:

In at least 30 counties in the South, black women in midlife now have a lower mortality rate than middle-aged white women, The Post found. That’s up from a single such county in 1999.

Among them is Newton County, Ga., southeast of Atlanta, where the death rate for black women ages 35 to 54 dropped from 472 per 100,000 to 234. The rate for white women went the other way, from 255 to 472.

The article cites researchers who speculate that new sources of stress are contributing to poor health and higher death rates.

The Post also connects areas with rising white death rates to those supporting Donald Trump’s presidential bid. That makes intuitive sense to me, although I don’t know whether there’s a causal link. What I will say is that those who vote for Donald Trump are going to be disappointed that he won’t be a stress reliever, even if he is somehow elected.

Image courtesy of Ohmega1982 at FreeDigitalPhotos.net

By healthcare business consultant David E. Williams, president of Health Business Group.

Most young men don’t know about emergency contraception. Is that ok?

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About 40 percent of adolescent boys and young men know about emergency contraception, aka the “morning after pill” or Plan B according to a Journal of Adolescent Health study. Women who take the pill within a few days of unprotected sex or a condom break can avoid an unwanted pregnancy because emergency contraception prevents ovulation.

So how should we think about the 40 percent number?

The authors are pleased that the number is as high as it is, and take it as proof that educational campaigns are working. They’d also like to see the number go higher so that boys and men take responsibility for contraceptive planning. In an ideal world that’s undoubtedly true, but I wonder whether it would be better if men were less aware of emergency contraception rather than more.

After all, the possibility of pregnancy is not the only reason to avoid unprotected sex. Prevention of sexually transmitted diseases is right up there as well. If boys and men know that emergency contraception is an option, they may be less careful about protection and more likely to pressure their partners into having unprotected sex in the first place.

I’m not actually advocating for purposefully keeping people in the dark, but I’d focus the awareness message heavily on girls and women.

Image courtesy of Stuart Miles at FreeDigitalPhotos.net

By healthcare business consultant David E. Williams, president of Health Business Group.