“Consumer-driven healthcare doesn’t work because people don’t want health care,” he said.
The three main factors that drive consumers to make a choice: price, quality and desire, said Cohen. When it comes to health care, however, price doesn’t correspond with quality, so going to a more expensive doctor doesn’t guarantee better treatment.
It’s also difficult to judge quality when it comes to health care, he said.
He gives the example of his own father getting a recommendation about a doctor not from his physician son, but from a nice guy in the lobby of the hospital.
“The guy sold doughnuts,” said Cohen.
People like to use service to judge quality, such as whether the doctor’s office calls back quickly, holds evening hours or has parking, rather than the more important measures like judgment and experience, he says. Patients have to do a lot more digging to get the more vital information and don’t know how to get the information or whom to ask.
Finally, desire is critical to being a critical consumer.
“It’s amazing what people will do when they really want something,” said Cohen, and in many cases, people don’t have such motivation when it comes to quality health care. For example, people with high-deductible plans or health savings plans tend not to spend money to get basic care, he says.