What healthcare will look like in 2020 | Stephen Klasko | TEDxPhiladelphia

What healthcare will look like in 2020 | Stephen Klasko | TEDxPhiladelphia

Translator: TED Translators admin
Reviewer: Queenie Lee
Well, I want to thank you all for coming,
and especially the people
that came from outside of Philadelphia
that hovered over here;
especially those of you that time-traveled
from other decades and times.
I’m Steve Klasko.
I’m the CEO of Stevie’s Vinyl Emporium
and Implantable Health Chips
in South Street in Philadelphia.
That’s what I am today.
But for the past ten years,
I’ve been the presidency
of Thomas Jefferson University
in Jefferson University Hospital System
that literally was one of the pioneers
along with several others
for what is now called
the leaders of the optimistic future
in Healthcare Revolution
from 2015 to 2024.
So for those of you
who are coming from another decade,
or for those of you
who are here in the 2020s,
I’d like to talk a little bit
about how that journey happened
and maybe give you
a little bit of the personal story
about how it happened for me.
So first one of the things that we did,
is we got tired of whining,
and we decided
let’s just travel to the future,
think about what we want
and then create it.
For me, that started in 1977.
Very important time for me,
I was a senior medical student.
It was important because I got asked
to give a talk for TED.
Now not the TED you’re thinking of
because TED didn’t exist in 1977.
It was called tomorrow’s
education of doctors.
It was everything different
than the technology that exists today.
It was a little slideshow with a screen,
but they asked me to talk about
what the future of medicine looks like
from a medical student’s point of view.
I remember it for it was the first time
I saw the Rolling Stones –
this is what they looked like
back then; I was a huge fan.
But what I talked about because I
was a little nervous about the first talk,
I talked about: Can you do anything
about spiraling costs?
Can you change the fee-for-service system,
so we’re really rewarding
value and not volume?
And can you measure outcomes?
And I said my generation of docs is going
to solve this over the next four years.
We are not going to be dealing with this
even 20 years from now.
Well, amazingly the docs said, “No.”
And that didn’t happen.
Now I was also a very different
person back in 1977.
This is what I look like.
(Applause) (Cheering)
Thank you.
That’s called a leisure suit.
But for a brief interlude
where they tried to bring it back in 2019,
I think it’s safe to say
it’s out of the fashion lexicon forever,
but the car was in 1968 GTO
which was and is a very cool car.
Thank you.
So then we went through really
what some people called
the middle or dark ages,
the Managed Care Revolution,
which did not really manage anything.
It didn’t really provide care;
it just promoted underutilization –
the balanced budget amendment,
which didn’t balance the budget,
and didn’t really amend anything.
And then the first iteration
of what has now been 17 iterations
of what was then called Obamacare.
So that brings us to 2014,
and why was 2014 important to me?
Well, I was very proud and honored
to be inaugurated and selected
as the first president and CEO
of Thomas Jefferson University
and Health System combined.
It was also a big moment for me
because it was the second time I saw them.
This is what the Rolling Stones
looked like back in 2014.
And in my inauguration
I was given a script,
and what I talked about
my inauguration in 2014 is:
“Hey, can we do anything
about spiraling costs?”
Can we change the fee-for-service?
Do you think we can measure outcomes?
That was a bit of an a-ha moment for me,
I said, “Well, 37 years, that’s a lot
for not to have much change.”
This time though, the insurers
and government said:
“We’re really going to do it.”
And really what people
were actually predicting is –
because believe it or not, even at 2014
the docs said: “I really don’t
want to take any risks.
I think things are fine
the way they were.”
And you couldn’t go a week
without people
threatening the extinction
of academic health centers.
So I’m proud to say here in Philadelphia
and at Jefferson we said yes,
and I’d love to talk to you a little bit
about what happened between 2014 and 2024.
So here we are in 2024, and by the way,
I don’t know if any of you saw it
on your Facebook implantable glasses,
the Zombie Rock Tour, it was awesome.
It was awesome.
By the way, those Facebook
implantable glasses
can be bought at Stevie’s Vinyl Records
and Implantable Devices.
I thought the Rolling Stones,
the Rolling Stones rocked,
(Laughter) (Cheers)
they rocked the undead tour, right?
Who agrees with me?
They rocked the undead tour.
Seven decades of great Rolling Stones.
You talk about
not getting any satisfaction,
look at these guys.
But more importantly, more importantly,
what happened in Philadelphia,
what happened at Jefferson was,
that we took that mode of saying –
people said that it’s impossible
to change healthcare.
And really the personal piece,
for me believe it or not,
didn’t come from Maimonides or Aristotle,
or even somebody from the University
of Pennsylvania or Jefferson.
It came from a sneaker commercial.
It was an Adidas marketing campaign
back in 2014 called the Impossible.
It said “impossible” is just a big word
thrown around by small men and women
who find it easier to live the world
they’ve been given
rather than explore the power
they have to change it.
Impossible is not a fact; it’s an opinion.
Impossible is temporary;
impossible is nothing.
So we decided, “What the heck,
let’s do the impossible.”
Because everybody knew
things were changing,
we weren’t going to wait for a miracle.
And we said, “Let’s do it.”
OK, so here it is, it’s March 28th, 2024.
Now I apologize for those of you
who come from this decade,
but I know some of you
probably have time travel lag,
and I just want you to know
where we’re at today.
So it’s March 28th, 2024,
President Jenna Bush will be debating
Democratic nominee Chelsea Clinton,
in what a lot of people think
will be a very tight race.
Harrison Ford has signed up
for one last Indiana Jones sequel,
tentatively titled Indiana Jones:
the Legend of Bingo Night,
we’re all excited about that one.
And the Eagles are 2-0
and trying to win their first Super Bowl
since the unprecedented fourth straight
they won from 2015 to 2018,
the so-called Chip Championship Years.
(Applause) (Cheering)
Of course, Governor Chip now has a very
different job than he had back then.
But more importantly or as importantly,
Jefferson is celebrating
its 200th anniversary
as an international hub of innovation,
with headquarters in Philadelphia,
instead of just the Philadelphia
academic medical center.
We’ve become a destination site
for innovative entrepreneurial health
with unprecedented economic development,
and our creative partnerships
have allowed us to become
what The Wall Street Journal called
a thriving cluster on the verge
of a chain reaction,
which has helped make Philadelphia
the epicenter of the new healthcare.
By the way, I’m getting out of my DeLorean
to accept an award from the US News
and Interplanetary Report.
As most of you know in 2019,
we found two other planets
with slightly dysfunctional
health systems,
so they are now part of the ranking system
that the former USNWR used.
So how did we get there? I’d like to …
TEDx has asked me to talk
about three things that we did
that were very different.
First of all, we decided that we’re going
to start to create docs of the future,
that it’s ridiculous to have the same way
that we selected and educated physicians
that became autonomous,
competitive, and hierarchical,
and that we actually were going
to change the DNA of healthcare
literally one physician at a time.
You may not believe this,
but back in 2014, we still chose doctors
based on science GPAs, MedCaTs,
which were a multiple-choice test,
and organic chemistry performance.
And somehow we were amazed
that doctors weren’t more empathetic,
communicative, and creative.
As my kids would say, “Duh.”
(Laughter) (Applause)
So we changed all that.
What we recognized is that it used to be
for those of you who came from the ’70s –
and I think there are actually some,
I see some people from 2014,
I see some people from the ’80s.
Go Journey, yeah.
I see some tie-dye out there,
some ’60s and ’70s. Peace!
But we decided to transform admissions.
What we realized is
that all the scientific data
is on what in 2014 we called
iPhones and Androids,
but really what we needed
were emotionally intelligent physicians.
So we now really select physicians
based on self-awareness, self-management,
and the ability to adapt,
social awareness and empathy,
relationship management, teamwork,
and the ability to really embrace change
instead of fighting it.
But not only that,
we totally changed the way that we teach
the physicians that we do accept.
Believe it or not back in 2014,
we used to spend two years
really teaching them scientific principles
in large auditoriums,
classes that a lot of them didn’t come to,
when we recognized
that we could do all that,
have them learn that
at two o’clock in the morning.
Now we spend most of our time
in what we call the Art of Attending.
Teaching them to really observe,
we started back in 2014,
workshops designed to sharpen
observation skills of health students
by looking at art.
Very unusual partnership,
it was Thomas Jefferson University,
Contemporary Art Museum,
an institute for an optimistic
future in healthcare.
We took students
and had them understand art.
So if you take
this piece of art over here,
medical students originally said,
“Well, that’s a woman;
that’s a snake; that’s a family.”
But when you started to look
and say, “What is the story?”,
it started to totally change the way
that they cared for patients.
And at the end of the day, we went
from silos of full-time individuals
to folks who could deliver
team-enabled and team-based care.
Doctors went from being captains
of the ship to being part of a team,
and they, believe it or not, work closely
with multidisciplinary
care-delivery teams,
including doctors of nursing practice,
nurse practitioners,
clinical pharmacists,
physician’s assistants.
and at the Thomas Jefferson Institute
of Emerging Health Professions,
professions that didn’t
even exist in 2014,
things like probability experts,
electronic health care ambassadors,
and telehealth professionals.
So we recognized that we needed
to evolve doctoring.
We also recognized that the patient
experience was really pretty lousy.
Back in 2014, you could actually
do anything you needed to do in travel,
anything you needed
to do in shopping on a device,
but could you get an appointment
with a physician? No.
Could you interact
with a doctor or nurse? No.
So we decided that healthcare needed
in 2014 to get into the E&I mode.
If you even look at how people
viewed us from TV shows –
how many of you are here from the ’70s?
There you go, okay.
So the big tip television show
in the ’70s was Marcus Welby.
Now here’s what Marcus Welby was.
He was a family physician.
He would get up in the morning,
he would go to the homeless shelter,
take care of people for free.
On the way home to lunch, a cow would
be having trouble delivering a calf,
he’d deliver it.
He’d then go to his family medicine
office in the afternoon,
and then at night he’d do
left ventricular neurosurgery.
We were Gods, we could do everything,
that’s how people viewed us.
In the 2010s this is what we had.
Anybody remember this guy?
He was a drug-addicted,
sex-addicted, really smart guy
that couldn’t communicate or see patients.
That’s what people viewed us.
The number one TV show of 2023?
Was Doctor WHO, which
stands for Watson Hybrid Organo Doc,
who basically fell in love
with his robotic-bionic counterpart
who does all the scientific stuff
while he does the emotional stuff.
And as you can imagine, hilarity ensues.
By the way …
By the way the first season of Doctor WHO
is available on Google Glass
implantable chips,
available at Stevie’s Vinyl Records
and Implantable Chips on South Street.
So the other thing we embraced
was entrepreneurship.
We recognized that being academic
and entrepreneurial
just were not mutually exclusive,
and we also recognized that we had
to enhance the consumer experience.
It really was lousy going to a physician.
This is what it looked like back in 2014.
Female: What’s wrong?
Stevenson: I don’t feel so good.
F: Then you need to go to a doctor.
Female nurse: Mr. Stephenson?
S: Stevenson.
FN: Do you have any allergies?
How would you describe your symptoms?
What is the general area of pain?
Does your family have a history
of heart disease or diabetes?
Doctor: And what seems
to be the problem today, Mr. Stevenson?
S: I’m feeling a little stuffed up.
I’m experiencing some …
FN: Doctor, your 3 o’clock is early,
your 2:45 is late from 6 and 7.
D: Follow these instructions;
if it doesn’t clear up in a week or two,
come back; we’ll do this all over again.
S: I don’t like going to a doctor.
SK: So in July of 2014, we partnered
with some great companies,
created an innovation-driven
ecosystem for healthcare.
Starting in 2015, patients in 48 states
could access Jefferson doctors
via telemedicine.
S: Well, now you can see a doctor
without going to a doctor’s office
with the help of your smartphone,
or computer, and American Well.
Signing up and setting up
your health profile is easy;
it only takes a minute,
and once you’ve done it,
it’s stored safely and securely.
Then you can log in or use the App
to see doctors who’re available,
and connect by video phone or chat.
D: Hi Allen.
I see you’ve been experiencing
some congestion and some nasal blockage.
How long has this been going on?
S: During the visit, the doctor
can see your health information,
afterward, you get a complete
write-up of everything the doctor says.
D: It looks like acute sinusitis,
a sinus infection.
Now I wrote you a prescription
to help with congestion.
If things don’t clear up
in, say, a week or so,
just send me a message,
I’ll be right here.
S: A few mins later, I’ve got my diagnosis
and my instructions for treatment
and my prescription is already
waiting for me at the pharmacy.
SK: Of course, all that now happens
in your Google Glasses
which are available by the way
at Stevie’s Vinyl Records
and Implantable Health Chips.
We also recognized
that information was everything.
As Yogi Berra would say,
it comes down to one word, big data.
And believe it or not, believe it or not,
we used to do everything
based on experience and anecdote.
Evidence-based medicine in 2014
was actually a novel idea.
And now we recognize that we can
take things from other industries.
So at Jefferson, for example,
in 2014, we started
the Center for Healthcare,
Entrepreneurship and Scientific Solutions.
We said, “It really doesn’t make any sense
that Nick Foles has a better idea
of whether or not a screen pass
will work in the third quarter
than I do of whether or not
a cancer drug will work.”
So we took some of the best people
doing mathematical modeling
and created a predictive analytics
and mathematical modeling
to reduce uncertainty in medicine.
Believe it or not, in 2014, 28% of people
that went to the hospital in this country
got readmitted within 90 days.
Now, through our mathematical modeling
we’re able to see exactly
what intervention
will keep people from coming back.
Not only that, we’ve changed
the way we do things.
In 2014, family medicine physicians
would actually be out of the hospital.
Hospitalists would never
leave the hospital,
and then there was no real communication.
Now we have what’s called extensiveness,
hospitalists that actually
follow those patients for 90 days
so they don’t get readmitted.
We actually pay for performance now
because we can actually
measure performance.
And we can actually
give you predictable answers
as to what you’re paying for
and what you’re getting back.
Accountable care organizations
for the first time really are accountable
because we have math to back it up.
One of the great things
that happened in Philadelphia,
believe it or not, again in 2014,
with decreasing NIH funding,
Penn, Jefferson, Temple, Drexel,
would all fight for NIH funds.
What we did, and one
of the greatest things we did,
we created the Philadelphia
Clinical Research Super Site
where we said really what’s important
is to take all of our resources,
both in education and research,
and make Philadelphia an epicenter.
What did that do for us
over the last ten years?
We were able to take the
Nanotechnology University of Pennsylvania
and Molecular Genomics at Jefferson
and create the DNA vending machine.
For those of you from the 2010s,
it’s sort of like a red box for your DNA.
We can now pick a drug for you,
and instead of saying it’s
for 200 people that look like you,
we can take exactly
the drug that fits your genome
and have it available for you.
We can also put your genome on a chip,
so that God forbid,
if you need a new organ,
we can make that for you
based on work that’s been done
in Philadelphia.
And we finally decided
to work with patients
to really make them
shareholders in their health,
and this is what it means.
It means that in a community
like Philadelphia,
if we’re able to make you healthier,
we do better as physicians; you do better.
And we actually partnered
with great companies
from again outside Philadelphia
to look at a different way
of making sure that everyone matters,
that we can look at not only drugs,
but holistic remedies
to look at personalized
performance-gain plans
integrating a proven system
to drive health outcomes.
Whether it’s mindset, or nutrition,
or movement, or recovery,
we were able to do many more things
that didn’t require pharmaceuticals.
So that brings us to 2024, and as I said,
I’m here to accept our number one ranking
from the US News and Interplanetary Report
and what’s really cool is
that some of the ranking parameters
didn’t even exist in 2014,
and I’ll give you an example
of a few of them on the academic side
and also on the clinical side.
On the academic side,
we actually, imagine this,
get ranked based on how our students do
at one year, three year, or five year.
We measure individuals’ professional
and personal happiness
at varying intervals after graduation.
Because after all, that’s why
they came to our university.
And if we don’t do really well,
then they actually
get some of their money back.
We have a collaborative quotient.
Academic entities are incentivized
to actually get over themselves
and work well with others,
(Laughter) (Applause)
which would have been unheard of in 2014
when they were all
cannibalizing each other.
And we have an entrepreneurial quotient
where institutions are rewarded
that invent and envision
new ways of doing things
that generate alternate revenue
and develop new student opportunities.
But probably nothing’s changed
the most than health quotients.
I mean, it used to be back
in 2014 and before
that parameters were based
on the reputational score in the past.
Now it’s based on what patients think.
The one I’m really proud of
that we got a very high score on
is called the BUB Quotient.
It stands for the
Believable Understandable Bill,
that we actually have enough
respect for patients
that we provide understandable bills,
so they can understand
what they got and what they’re paying for.
We have the say-what-you-mean
and mean-what-you-say quality parameter.
We actually take marketing professionals
to read all the billboards
in the marketing we do,
and see if they have any semblance
to reality of what really happens
in the hospital,
and you get points
if there is some semblance to reality.
And then finally we have
the through-the-patient-eyes factor.
And this is really exciting
because what it is,
is every patient now, in 2024,
basically when they get in the hospital
is given a Google Glasses,
and they basically can record
what’s happening through their eyes,
how the doctors and nurses
are treating them,
and then we have CEOs of other hospitals
look at that video for a day
and grade on 1 to 10 whether they’d like
to spend a day in that hospital.
And again that’s a great parameter for us.
So a lot has happened since 2024,
and I’m really excited to be here.
We’re about to accept an award
in the new Convention Center & Casino
on the Schuylkill River.
And some things
from the past really are good.
I’m going through my third midlife crisis
because I’m 70 and what happens
is people live to 120,
so midlife crises have changed.
And I’m proud to say
this is what I got myself,
I was able to retrofit a GTO
to hit the standards for a hovercraft.
Excuse me for a second, Google Glass out,
could you get the GTO to get ready
to go to the Convention Center?
Great. Thank you.
Listen, I want to really
thank you for being here,
I want to thank you
for traveling in time and space,
and most importantly,
stay healthy in Philadelphia.
Thank you very much.
(Applause) (Cheering)

100 thoughts on “What healthcare will look like in 2020 | Stephen Klasko | TEDxPhiladelphia”

  1. He hit on some major issues in healthcare. From the educational institutions to the over complex billing system.

  2. Very clever, funny and intellectually brilliant TED talk about where we need to go in health care. I loved the part of screening for Emotional Intelligence in medical school applicants.

  3. State health care guarantees a fair and low price for all. It works for us in Blighty; Canada; France; Germany etc.

  4. The future of healthcare discussed by Mr. Klasko
    I found to be very inspiring. He is part of the leaders of the optimistic
    future and healthcare revolution (2015-2024). He addressed three questions
    which are; what can we do about spiraling costs, can we change fee for service
    systems to reward value not volume, and can we measure the outcomes? The
    Jefferson University and Hospital systems he works with is addressing these
    questions and molding the future of healthcare. Some say that changing
    healthcare is impossible, but Mr. Klasko takes impossible as a challenge and
    realizes that impossible is a temporary opinion. With this optimistic view he
    along with other Jefferson staff have embraces the future technologies, intrapersonal
    relationships, new occupations, and methods. They in my opinion are changing
    the way we think about our current healthcare system. One of the first methods
    of change he suggested was to change the doctors of the future. The doctors of
    tomorrow need to have emotional awareness, and embrace change. Jefferson University
    is taking steps toward this goal in one example having the medical students
    look at art and explain the story. To enhance observation and empathy. The
    results of this outreach changed the doctors from a captain to part of a team.
    Next he addressed entrepreneurship to increase efficiency and make a better
    experience for the patient. This was answered by making doctor’s appointments face
    to face over devices from the patient’s home. Also there are probability mathematical
    models for prescriptions and problems which give the doctor the best choice of
    prescription due to the best probability of success. Furthermore the doctor can
    be in contact and “follow” the patient for ninety days to ensure the patient
    won’t return for the same problem. The last subject Mr. Klasko discussed was
    the advancements in the future. He started with the epicenter that Jefferson
    has already started. This epicenter has a DNA vending machine per say. The
    patient can get a drug to fit his or her genome. Another advancement mentioned
    was rewarding the doctors that come up with new and innovative ways to treat
    patients, as well as checking academic performance and happiness after
    graduation in the field. The patient will also receive understandable bill to
    know exactly what they are paying for. Quality parameters are to be made so
    doctors will say what they mean and mean what they say. Patients will also wear
    google goggles during their visits so those of that business can see if they
    are providing a positive experience in their own entity. Now there is no doubt
    that all these innovations will have positive aspects within healthcare, but
    what is not addressed is the fiscal effects of implementing these techniques
    into an already broken healthcare system. Now these innovations are needed to
    improve the overall health of the population and we must find a way to afford
    these improvement without government dollar. The reason I even bring this up is
    that our current healthcare can’t support the medical bills of today. So I
    suggest we come up with that answer first before implementing more. I wished
    that Mr. Klesko addressed that issue a bit more by ways of making money for
    these advancements at a lower cost to the consumer. In my opinion the possible
    damage that could happen if we jump the gun on these futuristic techniques
    would be catastrophic to the USA especially. The money has to come from
    somewhere to get these services, and more and more people are not provided good
    insurance. Therefore more and more go into the realm of the Affordable
    Healthcare Act. This government intervention into the healthcare system has
    caused our national debt to become larger than our worth (gross domestic product).
    If this trend continues the country in my opinion will implode like Greece did
    when they were on the same path. Now why do you think that I am bringing this
    case up? Don’t I care about people getting the best healthcare possible? Of course
    I do, but at what cost. This may be construed as Kantian moral theory choice,
    but in reality it would be an injustice to frame it that way. A Kantian would
    decline due to the fact of higher taxes on others, but my reason is a lot
    bigger. It would be like telling a toddler to stay away from a hot iron,
    because you know the result of the action is a lot worse than the value of the
    curiosity. The possibility of the implosion of the country due to increased
    government healthcare is there. So there is a chance that if that does happen
    there will be more death caused by the healthcare system than ever, because the
    healthcare bills could never be paid by those that were on that system and the
    competition of healthcare individuals will shift focus to those that have more
    money.  This event should not be
    acceptable to anyone in my opinion. To avoid this possibility, and not come up
    with ways to create capital enough to sustain the advancement without raising
    the patient’s bill would be reckless in my opinion. I’m sure if they put their
    minds to figuring out this problem the advancement would have the greatest
    impact overall on all parties involved, and I believe they can do that. Like
    Mr. Klasko stated impossible is only a temporary opinion, and I can’t wait to
    see the advancements in 2020.

  5. This video was very interesting and he made some really great points. He explained everything very well and had so much detail in his speech. He hit on some key points with healthcare and what it will look like in 2020.

  6. By taking an approach to viewing how the healthcare system can improve, I congratulate Dr. Klasko for taking one I had never thought of before. Now, there were some odd comments that he made that did not pertain to the topic of healthcare, but when he referred to the topic at hand, there were some interesting suggestions. When he stated that in the future, there would be a machine that matches a patient's DNA with the appropriate drugs, that is an intriguing idea. Just to know that someone in the healthcare field is thinking of that, I am delighted to know that even with current technological advancements, new and helpful ideas are being made. To show the beneficence of this idea, suppose that instead of having someone make a mistake in your prescription, a machine could prescribe you the exact medication you need. The action that Dr. Kraft proposes this machine could perform, would definitely benefit anyone that is looking for their appropriate prescription.

  7. I predict healthcare in the future will be like taking out a car loan or more like a mortgage. Need some kind of expensive $100k transplant? Look no further than you're bank on the brink of being like the mob just without the broken knee caps. You'll pay extortion fees + interest and heaven forbid you miss a payment.

    Obamacare is a good idea it was just don't in the wrong way. Cut out the middle man. Why pay the insurance co. go directly to the Drs and hospitals and cut out these theives. Funny thing is I'm forced to pay for Obama care and I still can't afford to go to the Dr. smh

  8. I predict healthcare in the future will be like taking out a car loan or more like a mortgage. Need some kind of expensive $100k transplant? Look no further than you're bank on the brink of being like the mob just without the broken knee caps. You'll pay extortion fees + interest and heaven forbid you miss a payment.

    Obamacare is a good idea it was just don't in the wrong way. Cut out the middle man. Why pay the insurance co. go directly to the Drs and hospitals and cut out these theives. Funny thing is I'm forced to pay for Obama care and I still can't afford to go to the Dr. smh

  9. If you want real solutions read these.
    David T. Beito. "The 'Lodge Practice Evil' Reconsidered: Medical Care Through Fraternal Societies, 1900-1930." (unpublished)

    David T. Beito. "Mutual Aid for Social Welfare: The Case of American Fraternal Societies." Critical Review, Vol. 4, no. 4 (Fall 1990).

    David Green. Reinventing Civil Society: The Rediscovery of Welfare Without Politics. Institute of Economic Affairs, London, 1993.

    David Green. Working Class Patients and the Medical Establishment: Self-Help in Britain from the Mid-Nineteenth Century to 1948. St. Martin's Press, New York, 1985.

    David Green & Lawrence Cromwell. Mutual Aid or Welfare State: Australia's Friendly Societies. Allen & Unwin, Sydney, 1984.

    P. Gosden. The Friendly Societies in England, 1815-1875. Manchester University Press, Manchester, 1961.

    P. Gosden. Self-Help: Voluntary Associations in the 19th Century. Batsford Press, London, 1973.

    Albert Loan. "Institutional Bases of the Spontaneous Order: Surety and Assurance." Humane Studies Review, Vol. 7, no. 1, 1991/92.

    Leslie Siddeley. "The Rise and Fall of Fraternal Insurance Organizations." Humane Studies Review, Vol. 7, no. 2, 1992.

    S. David Young. The Rule of Experts: Occupational Licensing in America. Cato Institute, Washington, 1987.

  10. Never ignore the law of unintended consequences. You can tell this man is not a clinician. The touchy feely stuff sounds nice, but that tele medicine doc better have some good malpractice coverage. And patients are not immortal. You can't keep them out of the hospital forever. By the way, how is pay for performance going to solve the physician shortage? What happens when docs unionize or go on strike? These sorts of ideas are quaint pleasantries, but the underlying fundamentals are much bigger economic hurdles to long term healthcare.

  11. Maybe Americans would be more indepedent and less in need of a healthcare system if we went back to eating organic foods like we used to. Why are corporations like Monsanto still allowed to get away with not labelling their toxic GMO foods? This leads to hidden long term health problems for Americans, and makes certain people with corporate investments in the heathcare and cancer industries very wealthy — the Medical and Big Pharma Mafias. This is why other countries that have healthcare systems for their citizens have outlawed toxic GMO's. They have seen the scientific evidence that has been kept hidden from Americans. If the human body is organic then the foods that it is fed should be organic too. Are we ignoring the fact that the Creator of this reality gave us everything we need to heal our bodies through the intelligence of Mother Nature? Maybe prevention is the missing key. I suppose that the blending of Western and (ancient) Eastern medicine might be an intelligent idea, too. By the way, one of my ex husbands is a surgeon, and he told me that in Medical school they are taught absolutely NOTHING about nutrition. Might this be because those that fund our medical schools and institutions have made a large part of their vast fortunes (Rothschild, Rockefeller, Monsanto) off of the backs of ill sheeple? THE SYSTEM "IS" RIGGED!!!

  12. After paying for healthcare for 30 years, I got bit by an insect and declined from a healthy, productive, beautiful individual to very ill person. My insurance enabled me to go to dozens of doctors, who did nothing but decline my requests for tests. They all preferred to refer me to other doctors, who then referred me to more doctors. After a few mos, my employer let me go. The symptoms progressed to the point where I could no longer drive, hair fell out, stools were white, and nails turned yellow. Vomiting, numb hands/feet, bloated stomach, dizziness, headaches, vision issues. Sold my house and spent over $100K and yet not a single Lyme, Chagas, or Zika Test. Request for a blood smear declined, GI workup declined, etc. No amount of money will fix the level of stupidity that our so-called medical professionals exhibit. These folks only want to dispense psych drugs in lieu of medical treatment. Our system is beyond broken.

  13. I love learning and Stephen Klasko makes it fun and interesting as well as challenging me to rethink. Congratulations Stephen on your evolution of the doctor patient and community relationship….and your hover GTO….I am from the 60s and 70s.

  14. Considering the topic that Stephen Klasko has given us on the way healthcare could possibly evolve into. We must think of the things that could possibly go wrong. Doctors and other physicians may not even want to have this happen because they might prefer face to face conversations. Doctors and other health care professionals might run along problems of people giving false information, faking illnesses, doctors would not have a way to physically see what is wrong with you, insurance issues, liability factors, and even waiting for a doctor to be available.    The American well app obviously seems like a fantastic time saving invention. But not all health care providers are going to want to sit at their computer talking to someone to give a diagnoses. Especially if that person has a speech impairment or even a strong accent that they cannot understand over a communication device. The healthcare provider might actually need to see the person and look at their lips in order to understand them if there is a connection issue during the conversation such as a lag. Along with this not all healthcare providers are up to speed just yet on technology since it is still relatively new. For instance, I know my family doctor refuses to get a smartphone because he thinks that it is killing the communication of our new generation.    Along with communication would be people giving the wrong information. The patients might lie about a past condition when they fill out their medical profile. If one of the patients is excelled in technology they might even be able to change what the doctor is seeing on their screen just to be able to get a certain medication. Although they could also change the info on the screen to get a free interview with the healthcare provider. This would be a problem because people would start to abuse the insurance policies and even try to find loopholes to not pay anything to the doctor who helped them.    The patients could even do things along the lines of faking an illness for someone else. They would do this for close family or friends who do not have the money to pay for a regular visit. Many girls or even guys in today’s time are very good make up artists and even scammers who try to stretch every penny so they have to pay little to no money. This could create a loophole for people who do not have insurance. These people would end up getting free healthcare anyway via help from a close friend or family member who faked an illness to get a prescription for someone else.    This brings up the topic of liability for the doctor who might be in contact with the patient. What would happen if a patient happened to use this app as a way to talk to a doctor if they were suicidal? What if that doctor does not have the specific training to get the person to the right help. Since the doctor isn’t there physically to prevent them from killing themselves, what happens if the patient ends their life because the doctor didn’t know what to say at that very moment? Would that doctor end up being liable for what happened in that instance?    Now what would happen if there was connection issues and the patient and doctor happened to disconnect. Would that person have to pay for “two” visits to the office? Would they be able to connect and continue right where they left off or have to restart the whole process. What if the patient is driving and just wants some quick tips on how to get rid of the flu but gets in a accident? Is the doctor liable for that?

  15. In this video, Stephen time travels to 2024 as is discussing the new healthcare policies that are in place. The new policies are patient focused and the training for doctors would be completely changed. This is unrealistic, unless if these changes are made fast which will not work anyway. If this is changed quickly doctors and other health professions will need to go through new training and most will not comply or not want to comply. Which would lead to an even bigger shortage of professional than we already have. Stephen’s plan is a great end goal and he pointed out plenty of flaws that the current healthcare system has. In the future we need to address these problems and find the best way to transition from one system to the next.

  16. Dr. K is amazing! I'm so glad I got the chance to meet him and shake his hand. Three years later, now as a PhD student, I find myself looking for him to be refreshed on a few of his new day ideas. The comments I had vaguely remembered were captured in this Ted talk…a m a z i n g!

  17. Dr. Klasko touched on multiple issues that we are going through right now, but also some that were problems back when he was a medical student that are still not completely fixed now. One thing that Dr. Klasko pointed out was that we still chose our doctors based on their scores and their grades from school instead of the morals and personal beliefs that they held, and then complained that the doctor was empathic enough or the right fit for that patient. But by recognizing now that we should choose physicians based on their social awareness, teamwork skills, and relationship management along with other qualities; we are allowing doctors to realize that they cannot be the “captain of the ship” and that they need to come down to the level with their coworkers and be a part of the team. Ethically, there needs to be some middle ground and balance between a doctor’s empathetic side and where they would step in and let their education take the wheel to deal with a patient. Although being more in touch with your patient and letting them know some of the views that are held can build a stronger doctor/patient relationship; there is a such thing as sharing too much and putting the doctors at risk for discipline taken against them for things that could revolve around their personal life. The futuristic fully virtual healthcare system that Dr. Klasko mentioned sounds like an amazing plan to start working on, but also would not completely work unless you had the cooperation of the doctors, the correct EHR and internet connection equipment, and a trust in your patients to not fake illnesses and add on to the current opioid problem. In short, the healthcare in 2020 can start to make a turn for a better futuristic start, but it is not a realistic goal to be reached in the next three years.

  18. I hear all the times "u have to pay" why??  the biggest  problem in the usa is the pharma industry !! fxb. "metroprolon" its a medicine for the heart  (cramps) for 100 pills u pay in America 125 $  ,in Mexico 6 $ and here in Denmark  about 2 $ .  so how can it be?? NHS that's it, very easy we pay 1,3% from our monthly paycheck and get FREE medical treatment (no matter what u have) and self when u cut a finger off NO MONEY (in the us between 6000$ and 17000 $ per finger) .America u should  think about a NHS.

  19. Stephen has a unique way to speak about how health care will change over the years, he begins with making some jokes about time travel. This was a great way to get people interested in the topic. Once he begins talking about the topic he explains that health care needs to become electronic, like other things people find it easier to use phones and get online to talk to someone. People prefer to go shopping online, and use one click to buy something. But you cannot get online and talk to someone about any medical problems you are experiencing. I think that being able to communicate with a physician online would be very beneficial for everyone. It would lessen the chance of becoming sick from contamination at the doctor’s office and it will save time for both the patient and the doctor. Stephen also talks about a DNA vending machine, it will put your genome on a chip and if you need a new organ later on, they can make one specifically for you. Although this idea sounds great, I think it is very unrealistic because doctors will not be able to put everyone’s genomes on different chips to use later. To put this in Immanuel Kant’s Deontological view, if putting every individual’s human genome was a universal law, it would not be a good universal law. I think it would fail as a universal law because there would be problems with the law and some individual’s beliefs. The health care will change from now until 2020, I just don’t believe it will change as much as this video believes.

  20. Thanks Dr. Klasko glad you are tongue and cheek, but I think the real issue if "Medicine by Chemistry" which is a failed experiment … so I hope your retraining of doctors takes in the consideration Hippocrates …
    Hippocratic Oath … “I will prevent disease whenever I can, for prevention is preferable to cure… “, has been forgotten …
    70 Going On 100.

  21. Dr. Klasko you forgot one HUGE detail in your prediction…

    Pres. Donald Drumpf and Paul Ryan's American Health Care Act
    – from 2016

  22. This is a huge mistake and it is obvious this doc is dettached from actual and real patient experience. The death of our health care system is giving the power to patients, insurance, and pharm companies and taking it away from docs by applying ridiculous service industry standards. Wrong approach!

  23. The notion of the future cannibalism of eachother. Great mesaage tha involves a team. Everyone is better at something than someone else. Accepting feedback and respecting eachothers ideas will grow the healthcare industry. Diversify and unify!! Great speech!!

  24. Now they have a gene sequencer for mobile phones.Its made by Oxford nanopore tech.Look it up.Just a matter of time before Google offers to sequence and store your sequenced genome…and make available all sorts of data for you.

  25. people should be able to pick their own doctors governments could deregulate licensing restrictions equals more doctors less cost lots of people trust healers but government created monopolies on practices and medicine outprice medical care for poor middle class private sector tax slaves. If north America hadn't enslaved itself with debt we could have done something about it . Greedy money worshipers

  26. sometimes the things that are in the present or the things that existed in the past are better then what is about to come next. the main culprit is human cannot stand one thing or system for long enough and gets in the race of changing it to his/her liking . In this journey of so called changing he/she is completely blinded in evaluating the pros and cons of the existing system or previous systems greatly motivated and supported by the big money makers”google glass”. I thinks only humans can heal humans not some robotics and other stuff. the simple solution to this is to train more physicians and train them to spend more time with the patients. A person when diseased is not only physically ill. The out come greatly depends upon what sort of mental support he gets when he arrives at the hospital. it is the human-human interaction that heals not human-ipad interaction. plus how can you tell the disease without touching your patient!! we live in a world where people are spending billions of dollars on useless healthcare technologies where there is a child dying in africa every three seconds. just think about it for a second. re evaluate yourself. pause for a second. Always ask is it for betterment or just your desire of fulfilling your dreams?

  27. you want to no what is to come. I will share with you threw the trials I have seen that simplu just need to be approved for public use. one stem cell cures its a shot of stem cells and a other things that can target most things and cure them thing like reversing damage from a heart attack stoke and more including helping people to walk again and talk again and bringing people back from the dead. we have for many years now froze are body in hopes to one day come back well for some that time can be now but is not do to the fda but will soon be. ever hade a cut that would not heal and needed to be stiched up and you hade to take antibiotics well no more with a ne age bandage you will be healed buy the next day if its super bad next week. over dosed on drugs and nothing is bring ing you back well now we can recover most people including people in a coma. the are feture is are past things we have had then but still cant use today but soon will when the fda approves them. do not believe me do some research.

  28. The health system promotes unhealthy lifestyles by introducing equal health insurance fоr all. This is unfair because some people invest in their health and others do not. The former do not weigh society with their illnesses, and the second ones swallow a lot of money to treat them. People need to get used to the idea that their health is above all their concern, not the state. The state must create a healthy environment and promote healthy lifestyles through an adequate policy, but also bring justice by punishing vices and rewarding efforts to maintain and improve health. Love from Bulgaria.

  29. Summary without the fluff- Thomas Jefferson University Health Systems are trying to select and educate doctors that provide compassionate, human-based care instead of someone who just looks at a list of symptoms and gives you pills. They are moving forward with Telemedicine to make healthcare more accessible. They are also implementing statistical methods to determine the treatments that will keep people from coming back to the hospital. Also talks about holistic healthcare and stepping away from a solely pharmaceutical system. So more about what they are doing to achieve a changed healthcare system

  30. Fun talk AND reinforces the fact that Dr. Klasko (like other physicians) doesn't have an eye on "the ball": treating and preventing chronic conditions. No improvements in drug selection, physician collaboration, or allopathic oriented analytics will fix that.

  31. Well if 2020 has a felon in office (GOP) we will continue to see higher prices for services we never wanted

  32. I’ve been a nurse for 25 yrs and a phone call for a diagnosis could have a bad outcome without being able to examine the patient. I false sense of security and is not patient centered healthcare.

  33. Hopefully the pharmaco MAFIA will be jailed, the suppressed cures for cancer and other diseases will be relieved, the ill people will be cured in a much easier way and for FREE. Sounds like utopia? Well, it's all achievable if the americans wake up and destroy the neoliberal globalist corporate dictatorship that is killing them and turning them slowly into zombies. A big american REVOLUTION is needed for a decent human living there.

  34. He could have focused more on molecular biology than gimmicks. Odd to think that Drexel is associated with any sites research considering one of their professors, george ciccariello-maher, is genocidal.

  35. 🤦🏻‍♀️🤦🏻‍♀️🤦🏻‍♀️🤦🏻‍♀️ I have had universal healthcare for over 52 years and it works. Is it perfect no but big pharma has no say, doctors don’t have to get ok for tests, I don’t have to worry about going into massive debt or worry about losing my home. Maybe this is why on average Canadians live longer than the US. Don’t believe all the people in the pockets of big pharma or the insurance companies. Yes we have wait times on non emergencies but know one dies 🙄. Emergencies are seen right away. I would never give up my healthcare.

  36. I despise modern healthcare. So disgusting….I didn't even watch this..I just hate healthcare done by modern money makers

  37. The healthcare industry is poised to witness a massive technological revolution in the coming days. Starting from AI, Big Data, Machine Learning to Virtual Reality, these technological innovations will undoubtedly improve the quality of healthcare for good in the coming days.

  38. If all medical information will be available on devices, why, apart from surgeons, would we need doctors? Would you pay a doctor just for emotional support?

  39. Agree, somewhat useless if we are already exposed to the use of telemedicine. Other than that, EI is what nurses have been taught for over 100 years. Way to catch up, fellas.

  40. My son started this year to study medicine in Uruguay, and believe it or not, my son is learning the same subjects described in the talk. They study communications, but not business communications, but the tools to pay attention to what is really the patient saying, they study the territory where they will mostly have their practices, ethics, and well, some medicine related subjects too. The career has changed some years ago, and this new program aims to form a different kind of doctors.

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