Consumers are the Ultimate Stakeholder in Health Care Reform


This week President Obama invited “stakeholders” in the health care system to the White House to seek their input about the best ways to reform health care. Representatives from hospitals, the insurance industry, medical device and pharmaceutical companies, labor and physicians came to discuss ways to lower health care costs across the board. Neither consumers nor nurse practitioners were among the invited stakeholders.

Also this month the Deloitte Center for Health Solutions (a subsidiary of the international consulting company Deloitte and Touche) published their analysis of a survey they of 4,001 American adult health care consumers. The survey (administered either in English or Spanish) sought information about the behaviors and attitudes of consumers regarding health care in six “zones” of consumer activity.

6 Zones of Health Care Consumer Activity – Selected Findings

Wellness & Healthy Living

  • 7 out of 8 Americans believe they are in good health.
  • More than half say they are putting effort into learning about their health risks, health problems, and learning to feel good emotionally and mentally.
  • Less than half say they act in ways that will improve their health.
  • 2 out of 3 smokers say they tried to quit in the last year, 2 out of 5 drinkers say they are trying to cut down, 44% are trying to reduce stress, 44% are trying to eat healthier, 39% say they are trying to lose weight, and 35% say they are exercising.

Traditional Health Services

  • 8 of 10 consumers have a primary care physician and 71% are satisfied.
  • Half believe that the quality of primary care varies among doctors.
  • Poor service and cost are the main reasons people switch physicians.
  • Consumers select physicians based on clinical reputation, out-of-pocket costs and the clinical philosophy of the practice.
  • Retail medicine is popular for primary care services because of its convenience and low cost.
  • Medication compliance is low – only 4 in 10 people say they take their medications as prescribed.

Alternative Health Services

  • Alternatives to traditional health services are attractive to a sizeable segment of consumers some of whom believe that traditional medicine is not optimal for treating their problem. Cost savings are secondary, but they are a factor.
  • Consumers frequently use alternative approaches without informing their physician.

Information Resources

  • Online resources to assist in decision-making are important to consumers.
  • For information about providers the most trusted websites are sponsored by doctors or medical practices (48%), medical associations (34%), independent health related websites (33%) and hospital associations (28%).
  • For information about the effectiveness and safety of treatment options, the most trusted websites are medical associations and academic medical centers (50% trust these sources); the least trusted are health plans and manufacturers (13% or less trust these sources).
  • Consumers want to control their health information and prefer providers who use Internet-based tools to augment care.

Health Insurance

  • Consumers are concerned about their ability to manage their health care costs.
  • Of consumers who skipped or delayed care recommended by a physician, 2 in 5 insured consumers (and 4 in 5 uninsured) did so because costs were too high.
  • Consumers prefer customized plans that offer comprehensive coverage (medical, dental, hospital, prescription drugs, wellness, holistic services), a wide network of providers, online resources to assist in self care and low premiums.
  • Given a choice, 70% said they would choose an enhanced plan with a wider network, coverage for traditional, alternative, and dental services, access to secure information systems, and availability of wellness and health management programs. 22% said they would choose the comprehensive plan (coverage for all services within a local area and prescription drugs. And 3% said they would choose a basic plan (coverage only for services in the case of a major accident or illness).

Health Policy

  • Reforms that increase access to care, prescription drugs, and insurance are widely supported. So is the use of performance-based payments.
  • Among those changes consumers want: 77% support improving benefits for veterans and military personnel; 74% support increasing teaching programs in medical schools to increase the supply of primary care physicians; 53% want employers to be required to provide health insurance, 49% support state laws to allow purchase of medications from Canada; 49% support increased funding for mental health services; 47% support nurse (practitioners) diagnosing and administering care, and 40% favor a performance based payment system based on outcomes rather than number or patients seen or services provided

There is more to this report than I can summarize here. You can download a PDF of Deloitte’s own summary here.

The Report’s Closing Thoughts

“Consumerism in health care is not a threat to stakeholders that recognize the value of connecting with end users who ultimately drive demand for the goods and services sold in the U.S. health care system. It is threatening only when stakeholders conclude that consumers are incapable of acting responsibly in their self-interest and are unwilling to take an active role.”

Here at Maverick Health we believe that you, the consumer, are the ultimate stakeholder. We believe that you should be the one in charge of your own health and your health care. We believe the health care system should be a service industry designed to help you direct your own care intelligently. True health reform will never happen until these other “stakeholders” start addressing your needs and your desires as health care consumers. For too long the health care industry has served itself first and consumers second. Until that changes there can be no reform.

Are you listening stakeholders and President Obama?

This information is offered for educational purposes only and is not intended to diagnose, prescribe or treat. For that please seek direct care from a health professional.

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