we’re not comfortable as health care consumers

December 19, 2011

in health care

a new, brief study by altarum institute finds that we’re simply not comfortable being health care consumers. as part of the study, altarum asked 3,000 people to answer basic questions like:

  • what kind of health care insurance do you have?
  • what role would you prefer to play in important decisions about your medical treatment?
  • have you ever asked how much your visit would cost before going to the doctor?
  • when you received advice or services from a nurse, doctor, laboratory or hospital in the past 12 months, did you look for information about ratings of doctor quality before choosing where to go?

these aren’t challenging questions. in fact, if you switched out the health care focus and inserted house- or car-related topics, every one of us could answer the questions. we’d probably all have stories to tell about how many car repair shops we visited before settling on one or how many home contractors we haggled with over price.

when it comes to health care, however, things get shaky. we want to defer to medical providers or we’re uncertain whether we should question them. after all, they’re the experts. we’re also unable to investigate and compare. comparison shopping for health care isn’t as simple as visiting an expedia, amazon or consumer reports. today, the tools for finding out how much a visit costs or comparing providers are largely nonexistent, or extremely clunky.

that’s beginning to change. tools are becoming available that will make it easier to comparison shop. castlight health, for example, offers employers a way to provide employees personalized information on cost, quality and convenience. but being able to comparison shop is only half the battle. the rest lies with making us want to pick up the sword as health care consumers. this, too, is changing. the quantified self and e-patient movements have captured a segment of the population, and more people are looking online for health information. one in five internet users has gone online to find someone who shares their health condition, according to a peer-to-peer health study done by pew.

what the pew study suggests is that we’re comfortable investigating things in health that we’re comfortable investigating in other areas of our lives. we’re comfortable asking questions like: has this ever happened to you? how did you deal with it? what suggestions do you have for coping? the pew study also found that we’re more likely to investigate when we have a health crisis.

the altarum study suggests that we’re not accustomed to thinking about, let alone investigating, routine things, such as the cost of services or the quality of health care providers. watch this video to see how wildly participants fluctuate in their estimate of the cost of different services.

it boils down to this: employers have work to do. employers who want their employees to act as health care consumers will need to step in and teach them how to find and use these newly available tools—and tell them they have an obligation to themselves and their company to do so.


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Greg Matthews December 19, 2011 at 12:03 pm

Totally agree with your conclusion here, Fran. I think that there are a few parts of the healthcare system that have a good financial incentive to making sure that consumers are informed – including insurance companies, employers and the consumers themselves.

There are also a few who have no financial incentive to ensure that consumers are informed – including doctors, hospitals and pharma companies. NOTE: I am not implying that these folks have *no* incentive to educate consumers … I said that they had no *financial* incentive to do so.

As long as our system has such skewed and contradictory incentives built into it, consumers are going to have a tough time making heads or tails of the financials, so those of us in a position to do so need to be extra-aggressive in helping out. Thanks for sharing!


fran December 20, 2011 at 3:45 pm

hey greg. on the incentive piece, interesting comment. i’ve long wondered whether we can get provider networks aligned with employers’ interests so they can steer patients to employer-provided benefits. it’s too unwieldy and fragmented, though. did you ever do anything at humana to connect provider networks and employers?



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