The doctor of the future will see you in person or by web cam, communicate directly or via e-mail, schedule appointements online, and will only take cash.

This is the vision proposed in a recent article in Fast Company, “The Doctor of the Future.”

This article profiles a new medical portal Myca  and a new health service, Hello Health  that runs on it. Essentially, Hello Health is a web storefront and social networking site focused on health care. The thing that makes this so interesting from a cash-pay perspective is the business model. Hello Health takes only cash, you have to subscribe to the service for $35 per month and pay for visits and other services as needed. Hello Health does not bill or take insurance claims. The subscriber can elect to submit receipts to their insurance if that insurance allows out-of-plan physician visits.

The other end of this cash pay system is about knowing how much the subscriber should pay for other services, even services not offered by Hello Health. Hello Health will provide the subscriber with information on how much should be spent on a given service and recommend providers in the area.

This is evidence that the health care market is changing. Providers will be competing on a more level field where patients armed with information about the market will be making more informed decisions. These patients will be supported by medical groups and physicians that understand the needs of patients who are managing their own health care dollar. The doctor of the future will be online and ready to provide patients with recommendations for their health care and their spending for health care.

If you are in your 20s and shun health insurance either because your age makes you feel invulnerable or because you find health insurance outrageously expensive, you are not alone. The health industry calls you the “Young Invincible.”

In other words, you are “willingly uninsured”! The Young Invincible along, with many other self employed people in the US are willingly uninsured or underinsured. They can afford the premiums but would rather take the risk and save that money for something else.

As Young Invincible you also have not one, but two top honors:

First: you are the nation’s largest group of uninsured— there were 13.2 million uninsured nationally in 2007, or 29 percent of the population, according to the latest figures from the Commonwealth Fund, a nonprofit research group in New York.

Second: you are the insurer’s top choice as a target customer. You are least likely to use services the health insurer will have to pay for. Your health premium goes a long way in paying for health services utilized by the “high risk” population, the older and the not so healthy.

This is how the insurance system works. The healthy pay for the sick, in the hope that when they, the healthy, get sick the next set of healthy people will pay for them.

As a Young Invincible whether to get health insurance, and if you do decide to, what type of health insurance you should get depends on your risk tolerance, your health condition, and your employment status.

We at HealDeal believe that there should be alternatives available to people without health insurance or government coverage. If you passed the “Young Invincible” test, you fall in that category and you should also have the choices and power to demand better value from your health care spending $$$. That’s why we build this platform, to empower you the same way the insured folks are.

We would love to hear your opinion. After all, you are the generation that will be shaping the future of healthcare in this country. Send us an email at feedback@healdeal.com or post it right here.

The average American’s household’s health care spending in the next 20 years will exceed 41% of the household income an increase of nearly 20%. This prediction by the outgoing secretary of Health and Human Services, Michael Leavitt assumes that the health care industry and current legislation do not change and the cost of health care continues to rise at the current pace.

What is the cause of this increase?  Several factors contribute to this prediction; the current economic climate is of course a leading factor, an increase in the elderly population relative to the working population (the baby boomers are aging and living longer), an increase of more and more complicated procedures that drive up the cost of health care services (hip and knee replacements as well as cardiovascular procedures account for the top three hospital procedures.) These factors are in one sense a given, we cannot reduce the number of elderly and cannot impede the progress of health care procedures that improve longevity and quality of life. The one factor that secretary Leavitt identifies as a way to reduce this health care burden is to provide health care recipients with the cost of procedures up front.

Currently there is little or no accountability and no process for comparing prices for common procedures. This Leavitt likens to an auto manufacturer accepting the cost of an automobile component and simply passing on the cost to the consumer. If health care providers were forced to compete in the marketplace the costs of all health care would be reduced directly for consumers as well as indirectly in a reduction of government health care spending and a potential reduction in taxes.

What can we do? As consumers of health care we can demand open and transparent pricing, value comparisons across providers and access to information to make informed decisions.Our mission at HealDeal is to:

• Provide an understanding of the consumer driven health care marketplace. 
• Empower the consumer with health related cost and quality information to improve the ability to make smart choices.
• Champion transparency in the health care marketplace that promotes value and cost comparisons.

This is a step in the direction of a transparent and open health care marketplace.

Even though I was attending the Health2.0 conference for the last 12 hours and it is quite late in the evening, but I can’t help but write all about a great experience. I congratulate Indu Subaiya and Matthew Holt to put together this (sold-out) conference.

A room full of innovation and disruptive ideas was very intellectually stimulating.

It started with the big players in the search space like Google, Microsoft, Yahoo and WebMD who lightly touched their plans of expanding in the customized search for consumers.

Followed was a panel of new(er) players in Healthcare with impressive presentations from Healia, Kosmix and Healthline. The interesting use of ‘natural language’ search and utilizing trusted sources for health information was fascinating. But I found it very hard to imagine the adoption of these powerful tools by our ‘average patient’- our consumer. What was missing was easy to understand customized abstracts relevant to the consumers.

Social media panel was highlighted by Sophia’s Garden and PatientsLikeMe, that were born out of personal suffering. Popular patient community Daily Strength is remarkable in having a great user experience. MedHelp as a veteran player has an accomplished group Physician community, from leading institutions, backing its reputation and building relationship with the consumers.

The panel on tools for consumers health got well moderated by Scott and had a great presentation about Quicken Health a very adoptable solution from already successful Intuit.

For me as a physician, the highlight of the evening was Provider networking panel especially Sermo and Within 3. These virtual physician lounges provide an unprecedented opportunities to the providers to improve the standards of care delivery and clinical research.

Looking ahead I see the need to collect all this fragmented information spaces into a healthcare bazaar with a trusted personal shopper to advise you.

Archana Dubey, MD

As the responsibility of healthcare financing and decision making has shifted from employer to provider and now to the consumer, the healthcare market is responding with innovation.

Consumer driven healthcare like the Lumenos plan offered by WellPoint, Inc. targets consumer involvement in managing their healthcare related finances.

Healthcare savings accounts coupled with high deductible health insurance plans split the risk between insurance and consumers with tax savings advantage.

With more Health 2.0 technology, this landscape seems to be getting healthier.

Archana Dubey, MD