December 18, 2019

From a socio-historical standpoint, when humans gathered in large groups, individuals within those groups tended to remain quiet so as not to unduly draw negative attention.   Given that natural tendency toward timidity, we enjoyed all the more those characters invented by storytellers over the centuries who were actually unafraid to speak their minds—like the orphan Oliver Twist who bravely requested more gruel in the midst of his peers or the plucky Clara Peller who defiantly asked, “where’s the beef?,” in the middle of a crowded burger joint.  In spite of the adage about being seen but not heard, it took a child to publicly point out that the emperor had no clothes.  These examples of singular outspokenness in the midst of the masses’ muted acquiescence demonstrate just how rare it was for a person to “say it proud and say it out loud.”

However, with today’s emphasis on self-expression, and our near obsession with social media, millions of Americans have become quite accustomed to making their views known to a mass audience on a myriad of topics.  People no longer hesitate to let the world know exactly what they’re thinking in the form of a Facebook post, Instagram message, Snapchat pic or Twitter tweet.  The days of deferential conformity are over.  We will no longer remain silent.

A Piece of Our Mind

One of the things Americans are vocalizing these days is their take on the nation’s healthcare system.  Their views are being loudly voiced and we in the healthcare industry need to hear what they’re saying.  Perhaps the best way to scientifically measure the breadth and volume of these views is through a well-designed and sufficiently-deployed healthcare survey.  Wouldn’t it be nice to know what your customers, and even your workers, are thinking when it comes to the efficiency and adequacy and cost of medical services?

Wolters Kluwer Health (WKH), a provider of professional information, software solutions, and healthcare services in 180 countries, has supplied such a survey in the last month, and it is amplifying loud and clear the concerns and priorities of the American people pertaining to the nation’s healthcare system.  The survey included nearly 2,000 patients, hospital executives, and clinicians across the country, and examined a wide range of issues.  In a nutshell, the survey findings—as reflected in the report, “Mending HealthCare in America 2020: Consumers & Cost”—showed some agreement, but also some divisions, in how consumers and clinicians view the state of American healthcare.

According to Diana Nole, CEO of WKH:

“. . . there has been a shift in attitudes surrounding out of control healthcare costs and a complicated and opaque healthcare system that erodes the trust of consumers and providers. Our national survey echoes this dissatisfaction, but also illuminates that those on the front lines of delivering care are taking diverging, and sometimes conflicting, paths to mitigate their concerns and prioritize actions.”

It is natural that there will occasionally be some variance between the public’s perception and the practitioner’s perspective when it comes to analyzing and fixing the healthcare system.  Those inside the industry don’t want to accept all the blame and those outside are prone to lob broadsides against everyone else.  Somewhere in the middle, there is the truth.  Surveys can tell us what people are thinking, but that does not necessarily get us to the truth.

The Survey Says . . . !

As to the actual survey findings, some of the key statistical takeaways are as follows:

Differences in Cost of Care

Both patients and providers know there is a problem when it comes to cost-of-care differentials.   The report revealed that 98 percent of survey respondents, across the board, believe that healthcare is inconsistently delivered and that costs and care can vary by location, health system and even hospital department.  Two-thirds of consumers don’t believe they would be charged the same for a treatment or condition regardless of where they received care.  As if to reinforce this perception, 79 percent of doctors and nurses admitted that “cost to the patient” influences what treatments they recommend.

Hiding the Cost of Care

The report showed 87 percent of all respondents agree there is a lack of transparency in the pricing of healthcare services.  This includes those who are prescribing medications.  The survey revealed that even those in the industry who are relatively optimistic about the prospect of positive changes in the system, generally, are nevertheless somewhat doubtful that such changes will lead to greater price transparency.

Behavior Based on Cost of Care

According to the WKH report, patients are more willing these days to ignore their doctor’s orders and seek care at an alternative facility based on differences in treatment costs.  As an indication of how critical cost has become to the American consumer when he or she is faced with a healthcare decision, just check out these survey findings:

• 52 percent of patients indicated they don’t always fill medications prescribed to them due to the cost
• 61 percent of millennials did not obtain a recommended medical treatment because of cost factors—reflecting a figure that is nearly double that of baby boomers (31 percent)

Quality Matters

Significantly, the report revealed that 78 percent of consumers will drive past the hospital closest to them in order to secure care at a facility with a better reputation.  This is a staggering figure, and should cause an all-hands-on-deck response at under-performing hospitals.  You simply cannot afford to have nearly four out of every five potential patients who live near you to pass you by on their way to another facility.  If your own local consumers are rejecting what you have to offer, you can forget about those farther away seeking you out.  That’s why quality matters.

A Political Football

The WKH report strongly suggests that healthcare will be a major factor in the 2020 elections.  A majority of survey respondents indicated that a candidate’s stand on rising healthcare costs will be key when they cast their ballots.  Some of the specific findings that may prove critical to those running for office are as follows:

• 89 percent of consumers believe the healthcare system needs an overhaul regardless of who wins in 2020
• 73 percent say the issue of healthcare will be a main factor when they vote for a presidential candidate
• 78 percent of all respondents say they will vote for the presidential candidate who will respond to rising healthcare premiums and high deductibles

To sum up, the American people are telling us that healthcare quality, availability and affordability matter, and they will be holding politicians accountable next November.  Those who have shown an unwillingness to make fundamental changes to the current system may suffer at the hands of those promising a new paradigm of patient-centered solutions.  This may be one reason Congress is currently considering bipartisan measures to end so-called “surprise medical bills.”  Public pressure and public outcry do have a way of bringing change.