Those poor healthcare consumers…

Another post of mine at the World Health Care Blog:

 If I got a nickel for every time I heard the word consumers here at the WHCC, I’d be a bajillionaire.

If I got a nickel for every time I heard someone use the word consumer appropriately, I’d be broke as a bad joke. 

consumer |kənˈsoōmər|
a person who purchases goods and services for personal use : [as adj. ] consumer demand.
• a person or thing that eats or uses something : Scandinavians are the largest consumers of rye.

The first definition is appropriate to someone who is buying a new laptop. They go online, search “PriceGrabber” for the best price, find the store with the best rating and/or the one they’ve had a previously good experience with, enter their credit card information, and a few days later that shiny new laptop shows up on their doorstep. It’s a lovely, painless experience. It’s actually enjoyable because you absolutely know you’ve spent your hard-earned money on something you value. This is the true consumer experience mastered by the retail industry.

It’s non-existent in healthcare.

The second definition is appropriate to someone or something that consumes a resource — we consume oxygen, we consume rye, bacteria consumes glucose, etc.. This definition often has little to no direct personal monetary expenditure. This definition seems almost synonymous with intake or consumption of a resource we need to survive.

The second definition seems more in line with healthcare.

We consume antibiotics and doctor visits to prolong life.

Please stop calling them consumers.  Call them healthcare users.

Until you can offer healthcare users consumer benefits on par with actual retail stores in America, you cannot call them consumers.  They are users.

 This is a perfect example of an entire industry slowly changing the true meaning of a word without anyone noticing to advance an agenda.  

Let’s talk about the characteristics of people who use healthcare in the US:

1. They spend someone else’s money on routine and specialized goods and services. “The United States has the best healthcare someone else can buy.”

2. They have no easy way to gain knowledge when they need it (like Pricegrabber) about how much they will “spend” on a given service and, often times, product.

3. If they do have knowledge about the amount they’ll spend, it’s often in the form of the amount of the co-pay (a heavily discounted price that cheapens the value of a doctor’s visit to a near meaningless ten dollar bill).

4. There is no way to shop for value.

5. There is no way to have the consumer experience similar to a visit to the Apple Store because doctors are paid for volume rather than the retail consumer experience.

6. Online rating systems are terribly flawed. Only people with an agenda (either a great experience or negative experience) go out of their way to rate their doctors. Therefore, “consumers” have no ability to measure value.

7. Value, in the mind of the consumer, is how long they waited for an appointment, how long they waited in the doctor’s office, how much they had to pay for the medication they were prescribed by a physician, and how much of the transaction their insurance covered.

8. All of these “values” are worsening in the minds of consumers in the current healthcare climate due to the trends showing an ever-increasing cost-shifting to employees and decreasing physician reimbursements causing an increased volume of patients in the doctor’s offices.

9. Value, to consumers, is increasingly becoming “Did I actually see my doctor?”

There are three “consumers” of healthcare — doctors, patients, and insurance companies. Doctors write the grocery list, patients go the grocery store to pick up the items on the list, and insurance companies pick up the tab at the end of the month.

Doctors are absolutely clueless about how much things cost but they nearly always order the juiciest filet mignon — they believe their perceived quality is associated with the taste. Patients are absolutely clueless about what things cost but they almost always want the filet mignon — they believe quality of care is associated with cost. And Insurance companies are near omniscient about healthcare costs and only want to pay for Spam.

Wouldn’t it be in everyone’s best interest (especially insurance companies) to arm both patients and doctors with cost information and cost-effectiveness data at the point of decision making? Wouldn’t it be appropriate to let the public know that cost of care is not associated with quality of care?

It would be appropriate, but it would affect your business models.

The bottom line is…patients are paying more for less, the consumer experience in healthcare is non-existent, and the morale of primary care doctors on the frontline is at an all-time low. Meanwhile, our “solutions” are just talk because there are too many golden geese laying too many golden eggs in a healthcare pond increasingly becoming an oligopoly.

But this is the beginning of a national crisis that will threaten our ability as a nation to compete in the global market and thus threaten the very existence of our nation as our healthcare spending rises to over 25% of our GDP in the next decade.

Bill Gates has said the only thing he’s afraid of is “some guy in a garage.”

He’s out there. But he’s not taking any hints from the Healthcare Industry about how to do things.