Like Syms … “Where An Educated Consumer is Our Best Customer” by Elmer Freeman

Last Monday, May 14th the Blue Cross Blue Shield of Massachusetts Foundation, the Massachusetts Health Policy Forum and the Massachusetts Medicaid Policy Institute co-sponsored a forum, “Massachusetts Health Reform: Progress, Prognosis and Possibility” with Governor Patrick, Secretary Bigby, Speaker of the House DiMasi, Senate President Murray, and Jon Kingsdale among others. According to them the progress is great, the prognosis is good and the possibility unlimited. However, the troubling take home message was that the success of Massachusetts Health Reform is all dependent on the Commonwealth having a citizenry of “educated consumers” like Syms, designer names for less.

Education to be focused on everything from understanding and selecting an available insurance option; to assessing quality in a physician, hospital or other health provider; to include understanding and managing a chronic disease, or two, not to mention an acute episode; and all the while reconciling the accounting on your health insurance account statements with premiums, co-pays and deductibles.

Fortunately or unfortunately, the reality is that we hold on to a “market” model for health care and health insurance that is incongruent with our market system principles of consumption. The problem is that consumers do not behave in the same way in the health care market as they do in the traditional economic market of goods and services. And there’s a reason for that. Obtaining health care is not like buying a car or refrigerator. The consumer (patient) of health care can’t choose to wait until there is “a sale on surgery” and doesn’t shop around for the “cheapest in-patient bed” they can find. We don’t negotiate the price for our prescription drugs, and with direct to consumer marketing, we insist that our physicians prescribe “the purple pill” for whatever ails us. And unlike life or car insurance, for which we pay, and don’t ever expect or want to have to collect on, we consume health services with a kind of gluttony.

In my first contribution to this blog I asked when we would get past the affordability debates to address the other elements of Chapter 58, quality and accountability. Well I got my answer on Monday, all we have to do is educate consumers and give them the information through the Connector’s version of Consumer Reports, and we can depend on the consumers to ensure quality and hold the health care market and system accountable. Ralph Nader, have we got a job for you!

Elmer Freeman, Executive Director, Center for Community Health Education Research and Service, Northeastern University; Co-Chair, Critical MASS