This blog is no longer being updated. I've begun a new blog, Wellness & Technology.

Three fiscal quarters into my new role at work I am pleasantly surprised to discover that CDHPs have quietly evolved from a disingenuous cost-sharing scheme foisted on workers by employers (see the Pollyannaish video, below) to a proactive, multifaceted approach intended to achieve “a pluralistic system that empowers patients and demands accountability from individuals and the health system, while adequately supporting the needs of the disadvantaged.”

Moreover, the criteria for determining whether or not these lofty goals are met are both simple and progressive:

1. Consumer-driven programs must encourage and attract enrollment from the sickest members as well as the healthy.
2. Consumer-driven programs must work for those members who don’t want to get involved in decision-making as well as for those who do.

Granted, the above is only Wye River Group’s take on the matter, but given that it comes directly from their An Employers’ Guide to Healthcare Consumerism which was published in 2006 I am inclined to take them at their word and note this as a sea change in suppliers’ attitudes towards the healthcare crisis in this country.

What Wye River Group refers to as healthcare consumerism is a synthesis of old and new ideas as well as delivery and payment models in the healthcare market. It encompasses consumer-driven health plans, value-based benefit design techniques, and good old-fashioned managed care (as opposed to managed access and/or managed costs).

Despite its name, healthcare consumerism isn’t mutually exclusive of government involvement. Indeed, the techniques it espouses could go a long way towards making the already superior healthcare model in place for US military veterans that much more cost-effective and efficient – not to mention portable to state and local governments and private industry.

There are few people as skeptical of for-profit payers as I am, but in light of this evolution of thought in the consumer-driven healthcare space I am open to – and hopeful at the prospect of being – proven wrong.

Last night's historic election of Barak Hussein Obama as the 44th President of these United States isn't just a watershed moment in American history, the U.S. civil rights movement, and world affairs; it also signals the turning of a new page in the realm of U.S. healthcare policy.

How many pages will be turned remains to be seen at the federal level, but here in Michigan two ballot proposals passed that will have immediate implications for those of us with an interest in health and wellness.

• Proposal 1, legalizing medical marijuana use at the state level passed with more than 60% of the vote.
  
  
• Proposal 2, which would allow the donation of unused embroyos from fertility clinics, passed by a more narrow margin, but passed nevertheless.
  

Both proposals were met with stiff and frequently hysterical and baseless opposition. Proposal 2 opponents wanted to see Michigan's ridiculous existing laws that punish researchers who utilize discarded human embroyos with a $5 million dollar fine and prison time remain on the books.

Proposal 1 opponents thought they knew better than Michigan's healthcare professionals and the patients themselves about the benefits and risks of medical marijuana use. They were wrong, the prohibition against medical marijuana use was wrong, and last night Michigan voters showed them just how wrong they were.

The era of politically sanctioned stupidity appears to be over - for now, at least. The triumph of reason and rationality over fear and ignorance in Michigan appears to have been replicated around the country. Also worth noting last night:

• Colorado's "Personhood" initiative that would repalce the science of pediatrics with one small group's narrow interpretaion of Christian scripture failed. (I can't help but point out that the initiative's "leading proponent" literally sat on the floor at a man's feet while watching the election returns - this picture pretty much sums-up where this sort of proposal comes from and where it ultimately leads to!)
  
  
• South Dakota's back-door attempt at setting up Roe v. Wade to be overturned failed. Again. Leaving a woman's right to choose where it belongs - in the capable hands of the woman herself and her doctor.
  
  
• In California, Proposition 8 is still too close to call. Given that homosexuality clearly exists in nature, I can only hope that Californians aren't duped by religious bigots peddling hate - and that when Proposition 8 fails, gay men and women are smart enough to treat the institution of marriage with more deference and respect than their heterosexual counterparts do. Clearly, America has come a long way towards waking itself from its self-induced eight-year nightmare, but it's equally clear we still have a long way to go.
  

Still, for the first time in a long time, we have something we haven't had to support us along the way: hope!

Actually, I made that last half of the title up, but it wouldn't surprise me if he did.

National Geographic News reported today that heterosexual men and homosexual women, and their respective opposites, share significant physiological and neurological similarities in their brains.

Differences both in the brain activity and anatomy were observed in a study involving 90 men and women, including homosexuals and heterosexuals of both genders.

The researchers monitored neural activity in the brain by charting blood flow.

The scans were carried out when the volunteers were resting and exposed to no external stimuli.

Researchers focused in particular on the amygdala, an almond-shaped structure inside each brain hemisphere associated with processing and storing emotions.

In homosexuals, brain activity most closely matched that of heterosexuals of the other sex.

Source: Gay Men, Straight Women Have Similar Brains

While the full implications of the study aren't yet clear, interesting observations were made that would seem to explain the origins of stereotypes about gay men being inherently more creative and "artistic" than their straight counterparts, and gay women so often being "butch:"

[T]he study found that straight men and gay women are both wired for a greater "fight or flight" response than gay men or straight women, the team reports this week in the journal Proceedings of the National Academy of Sciences.

Also, homosexual men and straight women showed significantly more neural connections across the two brain hemispheres than heterosexual men did.

ibid.

Of course, these are stereotypes. There are boorish, slovenly, aggressive and abusive gay men (I know, I've dated a couple of them) and there are "lipstick lesbians" who are indistinguishable from heterosexual "babes" except for their taste in men (which is to say, it's completely absent). Still, stereotypes, like myths, often have their basis in fact, however distorted or misunderstood those facts may be.

The study also doesn't do much to shed light on the (again, stereotypes) similarities between homosexual men and women and their heterosexual counterparts. For example, many biological determinists have posited that heterosexual males are driven by biology to copulate with as many partners as possible to propagate their genes. Assuming there's any validity to this argument at all, if gay men are "wired" like heterosexual women, where do the incidents that underlie the stereotype of the unfaithful, promiscuous gay man come from? Why "behave like a man," if you're "programmed" like a woman?

Conversely, if gay women are "wired" like heterosexual men, why aren't lesbians disproportionately more prone to violence and criminal behavior when compared to gay men the way that heterosexual men are when compared to heterosexual women?

While incidents of heterosexual women abusing their heterosexual male partners are almost certainly higher than reported numbers would indicate, males are more violent than females. Yet same-sex couples of both genders show the same levels of domestic violence as their heterosexual counterparts; how can this be if homosexual males are supposedly genetically predisposed towards flight and homosexual females are predisposed towards fight?

While I think the science of sexuality is interesting, I also think it's rather pointless because ultimately what it comes down to is what two (or more if that's your thing) consenting adults are comfortable with. Whatever that might be, if you've got a problem with it, it's your problem.