This was a good opinion piece that, in my opinion, really addressed more than one issue. In terms of Ken's take on healthcare consumerism, I think he's conflating the labeling of a movement for a more informed, involved healthcare patient consumer with the insanely over-regulated pharmaceutical industry and profit motive endemic in America and its healthcare delivery system. Consumerisn in healthcare is about putting more and better information into the hands and minds of an increasingly health literate American populace. I won’t address the longer, more detailed part of the article comparing how past and current pharmaceutical market realities bode ill for healthcare consumerism as I think these are largely two separate albeit related issues.
Here’s my take on healthcare consumerism
For too long people have just gone along with what the medical profession, health plans and supporting industries (device makers, pharmaceutical firms, imaging centers, labs, etc) have given them. They accepted what they got, may have grumbled a lot but went on with their lives. But with the ever increasing costs for healthcare services and the increasing shift of costs to individuals, people need to adopt a consumer mindset. Information empowers and emboldens. Look what the Internet has done for automobile, airline, hotel and entertainment consumers. Of course, people showing up at the ER with appendicitis, pancreatitis, or gall stones – and victims of traumatic injuries – are not going to be shopping around and will largely take what they can get. (i.e. be at the mercy of their local healthcare delivery system) but that's no reason to continue as we've been going with our healthcare purchases.
Too many people for too long a time have made little, if any, effort to participate in their healthcare decisions, opportunities and care. Providers and payers offered little helpful information; indeed they seemed to make what little information they did provide unduly complex and hard for the common person to understand. Hell, I’ve been in claims administration for 20+ years and sometimes still struggle to understand what certain providers and payers are giving to me.
Information Empowers and Emboldens – Effects Change
I appreciate that the “non-shopper” category can account for a majority of healthcare expenses in the U.S. But why shouldn’t those using non-emergent, non-critical services be consumers? We need to start somewhere. I don’t think we need to sway the non-shoppers as much as we have to sway the system. I suspect once healthcare consumerism become more widespread and supported by tools that innovative companies like HealthSparq, PokitDok, and Castlight Health provide, that a more empowered and embolden consumer will begin to demand change from the acute, emergent and critical care service sectors. So Ken and I agree that empowerment is a key aspect we need to advance.
One last point, and I suspect this won’t endear me to my social media friend Ken Congdon and others is that I would argue that individuals, collectively and individually, need to do what’s best for themselves the patient. But true change must start with the individual. Not from someone else. Not from the Government. Not from the elites that know what's best for you. Programs exist and can be implemented to help those that truly, honestly can't help themselves. But I argue that an organic, grass roots approach to changing the American healthcare delivery system will be more easily accepted and longer lasting than one imposed by government mandate and more regulations. As peoples health literacy increases and individuals have access to better and more complete information, the opportunities for change – whether voluntary, forced by a collective group of activist individuals or imposed by voters via regulation – will effect the positive change we all know is needed in the U.S. healthcare delivery system. Empowerment indeed.