Le Rôle de S&P dans la Situation
En mai, l’agence de notation américaine avait abaissé d’un cran la note française, de « AA » à « AA- », avec une perspective stable, réduisant les risques d’une nouvelle dégradation dans l’immédiat. Mais « il serait étonnant de ne pas avoir d’action défavorable concernant la France, avec au minimum un passage en perspective négative », avance Norbert Gaillard, économiste et consultant indépendant. Depuis le printemps, les « mauvaises nouvelles » se sont accumulées dans une France déjà lourdement endettée, figurant parmi les cancres européens, comme la dissolution de l’Assemblée nationale, « atermoiements » autour de la nomination du Premier ministre et « révisions alarmantes » des prévisions de déficit public.Les Conséquences d’une Perspective Négative
En octobre, Moody’s et Fitch avaient maintenu la note française en l’assortissant d’une perspective négative. Norbert Gaillard évoque deux autres scénarios éventuels : une nouvelle dégradation de la note ou son placement sous surveillance négative (« rating watch ») pour signaler un « stress important » susceptible d’évoluer rapidement. S&P accorderait alors un court sursis à la France avant d’ajuster sa notation. « Pour prendre sa décision, l’agence attendrait de voir le vote du budget, les mesures budgétaires et fiscales qu’il contient, et si le gouvernement se maintient ou chute », selon lui. Si une perspective devenant négative aurait peu d’impact sur les coûts d’emprunt de la France, les tensions seraient en revanche accrues en cas rétrogradation de la note, qui passerait dans une catégorie inférieure, jugée moins sûre par les grands investisseurs qui s’en détourneraient. Cela « impliquerait donc des ventes nettes de ses obligations sur les marchés, et ensuite une forte baisse de la demande. Cela entraînerait mécaniquement une hausse du taux de rendement », explique Éric Dor, directeur des études économiques à l’IESEG School of Management.Le Groupe Minoritaire et son Enjeu
Le gouvernement de Michel Barnier est minoritaire et avance en terrain miné. Il souhaite ramener le déficit public de 6,1 % du PIB en 2024 à 5 % en 2025, puis sous le plafond européen de 3 % en 2029, une trajectoire approuvée mardi par Bruxelles. Mais au terme d’âpres débats, il envisage de recourir à l’article 49-3 de la Constitution pour faire adopter sans vote les budgets de la Sécurité sociale et de l’État ainsi que l’exécution budgétaire pour 2024, risquant à chaque fois d’être renversé par une motion de censure de la gauche, que le RN menace de soutenir.Les Conséquences sur les Marchés Financiers
Cette éventualité aurait des conséquences sévères, selon Michel Barnier, qui a alerté mardi sur TF1 : « Il y aura une tempête probablement assez grave et des turbulences graves sur les marchés financiers. » Les marchés se montrent déjà agités. L’écart (« spread ») entre les taux souverains français à 10 ans et ceux de l’Allemagne, considérée comme une valeur refuge en Europe, a atteint mardi son plus haut niveau depuis 2012. Sans budget, « ça veut dire que le déficit public de notre pays continuerait à se creuser. Ça veut dire que les taux d’intérêt de notre dette continueraient à augmenter. On va arriver déjà à 60 milliards d’euros par an rien que pour les taux d’intérêt de notre dette. Est-ce qu’on veut que ça atteigne 70, 80 milliards? Non », a averti le ministre du Budget, Laurent Saint-Martin, sur France Inter. Déjà, les taux de la France sont supérieurs à ceux de l’Espagne et du Portugal, et avoisinent ceux de la Grèce, pourtant moins bien notés. « Les députés n’ont pas pris la mesure du défi qui est devant nous, c’est très inquiétant », regrette Norbert Gaillard alors que ce jeudi s’annonce un débat tendu à l’Assemblée nationale sur l’abrogation de la réforme des retraites de 2023.Unlock the Potential of Healthcare IT with Rapid Growth
Components and Their Impact
Based on components, the healthcare IT market is segmented into services, software, and hardware. In 2023, the services segment held the largest share. The growth of this segment can be attributed to healthcare organizations relying heavily on service providers for various aspects such as consulting, storage, implementation, training, maintenance, and regular upgrades of technologies and solutions. The introduction of complex software and the requirement for software integration and interoperability, which demand training and regular updates, have also contributed to the growth of the services segment. Moreover, the increasing demand for digital health solutions is driving patients towards distance healthcare services, especially after the COVID-19 pandemic, which emphasized the need for safe care and efficiency.
For instance, healthcare IT systems are minimizing medication errors by improving medication management, ensuring accurate documentation, and enhancing communication among healthcare teams. EHR systems can alert healthcare providers about potential drug interactions or incorrect dosages, making patient care safer and more efficient.
End Users and Their Growth
The healthcare provider segment is expected to register the fastest growth in the healthcare IT market. A significant share of this segment is attributed to patient engagement as patients increasingly seek personalized and accessible care. Advancements in technology like artificial intelligence (AI) and telehealth are transforming how patients interact with their care. This increased engagement not only improves patient satisfaction but also enhances the overall efficiency of healthcare services, making it essential for providers to invest in these technologies to stay competitive.
For example, in the United States, medication errors cause nearly 150,000 deaths each year and cost the industry about USD 20 billion annually. Healthcare IT systems play a crucial role in minimizing these errors and improving patient care.
Regional Segmentation and Dominance
The Healthcare IT market is segmented into five major regional segments: North America, Europe, Asia Pacific, Latin America, and Middle East and Africa. The North American region dominates the healthcare IT market due to the increasing adoption of health information technology (IT) solutions across healthcare settings. The interoperability used between laboratories, clinics, pharmacies, and hospitals allows for easy sharing of patient information and enables doctors and healthcare providers to quickly access and exchange electronic health records. Government initiatives led by the Office of the National Coordinator for Health Information Technology (ONC) also contribute to this dominance. These initiatives focus on improving health IT systems, enhancing interoperability, and advancing data sharing across healthcare providers.
For instance, the Assessing Use of Health IT by U.S. Physicians Providing Outpatient Care initiative received USD 425,000 in its first year to fund a five-year study. The Leading-Edge Acceleration Projects (LEAP) in Health Information Technology has various funding announcements each year focusing on innovative solutions in health IT. The ONC has also allocated funding for the Health Information Exchange (HIE) and Immunization Information System (IIS) programs, with a maximum award of USD 10 million aimed at enhancing data-sharing capabilities.
Key Players and Their Strategies
The healthcare IT market is dominated by key players. Optum, Inc. (part of the UnitedHealth Group) provides HCIT solutions to healthcare payers, providers, employers, and government & life science companies. The company serves its solutions and services to more than 280 healthcare payers, 5,000 hospitals, and over 100,000 healthcare facilities in the US. It focuses on forming strategic partnerships and driving innovation in digital health solutions to enhance patient care and reduce costs.
For example, in the last two years, Optum has invested USD 31 billion into acquisitions. A notable example is the recent completion of a USD 7.8 billion merger with Change Healthcare, which gave them access to data from millions of healthcare transactions and boosted their IT capabilities for the US population.
Cognizant is an IT, consulting, and business process services company. It provides digital services and solutions, consulting, application development, systems integration, application testing, application maintenance, infrastructure, and business processes. The company operates in major metropolitan areas across nearly 50 countries and has a large presence in India.
For instance, in July 2024, Cognizant partnered with Unity water to sign a five-year deal to upgrade its digital infrastructure and improve operational efficiency. In December 2023, Cognizant acquired Thirdera to strengthen its digital transformation efforts and spur a USD 1 billion AI-driven automation business.
Oracle Corporation is one of the world's largest technology companies with revenue of about USD 53 billion for fiscal year 2024. It recently made a significant acquisition of USD 28.4 billion in June 2022 to enhance its presence in healthcare by acquiring Cerner Corporation. This allows Oracle to use advanced analytics and artificial intelligence in EHR. Oracle Health has extended its EHR contract with the VA until 2024 and announced new partnerships to improve patient care and operational efficiency through initiatives in cybersecurity and interoperability. Oracle's Health Data Warehouse has emerged as a leading healthcare IT solution, with users achieving a strong 417% return on investment (ROI) during five years.
Transform Your Phone Habits with Intenty
Understanding the Problem
Intentional phone usage is a complex habit to break. Platforms like iOS and Android, along with social media networks like Instagram and TikTok, have introduced timers and controls. However, we still find ourselves unlocking our phones out of habit without a clear purpose. This was the problem that inspired Yaroslav Neznaradko to create the Intenty app.
Neznaradko himself faced the issue in 2019 when he spent excessive time on his phone. He tried traditional methods like screen time limits and app blockers but found them ineffective. This led him to the idea of making users state and evaluate their intentions before using the phone.
The Initial Version and Its Limitations
In 2020, Neznaradko released an initial version of the Intenty app. It was limited to asking users one question about why they were unlocking their devices. He also developed an iOS version but faced limitations on that platform. The project stalled until 2023.
Last year, he rebranded the app as Intenty and focused on the Android version. He initially tried a chat styled interface to ask users about their intentions when unlocking the phone, but it didn't gain much traction.
Redesigned for Customization
This summer, Neznaradko released a redesigned version of the Intenty app that allows users to customize nudges. Users can select from various categories such as Intention, Necessity, Grounding, Posture, and Minimalism. Each category has a set of prompts, and users can even add their own.
While users have the option to swipe out of the nudge screen to avoid entering a reason, this defeats the purpose of the app. The app also allows users to set a cooldown time to prevent nudges from appearing immediately after locking the phone. Additionally, users can set the intensity of nudge pop-ups, choosing to have them appear on every 2nd, 3rd, 5th, or 10th unlock.
Tracking and Insights
The Intenty app keeps a history of users' answer logs and the number of times they unlock their phones over time. This provides valuable insights into users' phone usage patterns.
Free vs. Premium Features
The Intenty app is free to use. However, for additional features like scheduling nudges, a hard mode that forces users to enter a reason, and a lock button to lock the phone from the nudge screen, users can pay $1.99 per month.
Comparing with Other Apps
There are other apps available that help reduce screen time, such as One Sec, which shows exercises or actions when opening a social media app, and Minimalist Screen Time, which limits the functionality of the phone. Each app offers unique features to help users manage their phone usage.
Future Developments
Neznaradko is continuously working on improving the Intenty app. He is exploring ways to create reminders or pop-ups during long phone usage sessions to prevent overuse. He is also looking at ways to address fatigue from nudges and automatically refresh prompt content.
In the long term, he plans to add image or video nudges to enhance the user experience and provide more engaging ways to interact with the app.