Effects of Consumerism
Consumerism in Healthcare
Reform critics referred to consumerism as a disruptive force to effective and efficient healthcare delivery. Several issues are still left unaddressed in the healthcare sector such as full optimization of healthcare delivery, payment mechanisms, consumers acting as the reformers, and supply versus the shift in demand. These issues are driven by forces such as pervasiveness of technology, rise of transparency, globalization, and medical tourism, social media and inconvenient care models that in effect insinuate consumerism in the healthcare sector.
Consumerism affects the quality of care received in terms of limiting the options available for the patients. In one of the conducted studies, McGlynn et al. (2003) evaluated the quality of care in the United States based on 30 different medical conditions common among patients. The study reveal that only 54.9% out of the 439 examined markers are able to get the recommended care they need. The rationale behind that is the cost imposed by healthcare insurance companies to care plans and the predefined benefits that are either limited due to plan price or applied plan policies. Healthcare plans are being sold to the public as a beneficial commodity, which in return encompasses its nature of consumerism. However, patients as consumers of healthcare benefits are segmented according to their financial capacity, which on the other hand limits their opportunity to acquire quality care.
On the other hand, Consumer Directed Health Care of CDHC that recently emerged as a vital healthcare reform agenda stated that while healthcare cost is high, its quality significantly declines. This is because the current insurance system have failed to provide consumers with incentives that will enable them to use care more efficiently and shop for higher value services (Buntin et al., 2006). The champions of CDHC insists that by providing consumers with incentives and to be in control of their health plans, they will be more engaged in controlling the cost and improvement of quality outcomes.
Furthermore, consumerism also has negative implications. For example, consumerist patients are possibly to follow their beliefs instead of their physicians. In effect, it undermines the authority of the physician to make decisions about regarding the patient’s health needs. This entails negative interaction between the care provider and the patient themselves. The reason behind it is that patients are more conscious about the cost of their care and hindrances such as their financial instability prevents them to deviate from the physician’s prescribed care. Cost is a fundamental concern that affects the quality of healthcare due to consumerism.
Access to Care
Economists and health policy experts alike is recently challenging the healthcare industry regarding its perception of consumerism. The reason behind that is that lowering the cost improving the quality and services would substantially allow the industry to reposition itself as a consumer market (Keckley et al., 2008). This argument also translates to the effect of consumerism in terms of access to care. Since healthcare users are regarded as consumers, they expect to experience the same service that they get from buying a consumer item. As a result, consumerism in health care enabled diversity in access to care. For example, consumers expect value by having access to websites and portals that were provided by their health plan including personal information, appointment schedule and prescription refills (Keckley et al., 2008). The old days of phoning for clinical checkups have changed since consumerism penetrated the health care sector.
Another apparent impact of consumerism on healthcare access is the occurrence of patient to provider sensitivity. Generally, medically necessary services are conceptualized as eminent candidate for coverage, which is also similar to out-of-pocket services such as vitamins and over-the-counter medications (Robinson, 2005). Such insurance services were optimally designed to include higher incentives on all sides of the market. In addition, the implication of such design is higher cost sharing for consumers, but significantly reduces incentives on the side of the care providers. For example, the patient’s access to services is being limited underneath deductible regardless if being financed by taxable income or HSA. It would still constitute the use of noninsured services. As the level of deductibles increases the need to access network discounts also increases (Robinson, 2005).
Consumerism also entails geographical differences in access. Normally, health insurance companies cover certain providers depending on the level and package designs of their health plan. At some point, the health services consumers are only limited to the prescribed care network and in order for them to optimize use of their health plan is to keep on getting services within the prescribed network, otherwise they will be opted to pay out-of-pocket. However, not all care networks are within reach of the patient and in some cases a suitable provider is within the locality of the consumer, but cannot use it because it is not recognized by their insurance coverage. In order for patients to take advantage of the best possible options for care regardless of geographical limitations, they could either move to higher plans or pay-out-of-pocket, which defines the consumerism aspect of the healthcare industry.
Consumerism and Trust
Healthcare thrives in the environment that is dominated by economics and free market. The current care practice rests under the paradigm defines it as a common consumer commodity. As a common misconception, physician-patient relationship is being established on the grounds of care. However, consumerism suggests that such relationship only exists because of the economic exchange of value and that it is plainly a continuous business transaction. On the other hand, healthcare consumers sees the relationship on a different perspective that involves trust and the major dilemma in between is whether consumerism has an apparent effect to such relationships.
In reference to the physician’s role, they embody the informative, paternalistic, interpretive and deliberative models. For example, Surgeons operate on the paternalistic model, which enabled them to make decisions beyond their personal intent. On the other hand, the informative model physician offers wide range of facts from which the patient would have to choose for him or herself. The interpretive model of physician-patient relationship requires the intuitive capacity of the care provider to determine the needs of the patient even if they were not openly divulged. Lastly, the deliberative model of relationship involves a more in-depth discussion in which the patient and the care provider come to a mutual decision. Although the four models suggests differences in healthcare approach the underlying principle is still based on trust and clear acknowledgement of the patient’s vulnerable nature that the physician should not undermine. Therefore, regardless of the model that occurs between the patient and the physician, consumerism affects the outcome of such models due to the commercial and fiduciary nature of the industry where these relationships exist.
Buntin, M. B., Damberg, C., Haviland, A., Kapur, K., Lurie, N., McDevitt, R., & Marquis, M. S. (2006). Consumer-Directed Health Care: Early Evidence About Effects On Cost And Quality. Health Affairs, 25(6), w516-w530. doi:10.1377/hlthaff.25.w516
Keckley, P., Coughlin, S., & Eselius, L. (2008). Deloitte Review Consumerism in Health Care Insights to engagement. Retrieved June 14, 2013, from http://www.deloitte.com/view/en_US/us/Insights/Browse-by-Content-Type/deloitte-review/c06a3d8240598310VgnVCM1000001956f00aRCRD.htm
McGlynn, E., Asch, S., Adams, J., Keesey, J., Hicks, J., DeCristofaro, A., Kerr, E., 2003. The Quality of Health Care Delivered to Adults in the United States. The New England Journal of Medicine, 348(26), pp 2635-2645
Robinson, J. C. (2005). Managed Consumerism In Health Care. Health Affairs, 24(6), 1478-1489. doi:10.1377/hlthaff.24.6.1478