by Ron Wince
As a small business owner providing coverage to my co-workers as well as a consultant to the various players in the health care industry I have seen firsthand the impact of not including the individual at the center of health care and health care reform. Waste and cost continues to explode despite the focus on efficiency, fraud goes unchecked with little sign of being harnessed, and only incremental improvement in quality. All of this takes place in a system where patients are told which providers they can use, where they can purchase insurance coverage, and from which pharmacy they must buy their medications. And as the debate over reform rages on the same thinking that created the system we have today is the same thinking that underlies many of the reform options on the table – that experts and/or bureaucracy is the best way to improve care, drive down cost and increase access to care.
But true reform must come from new thinking and new perspectives. Thinking and perspectives that only patients can provide. Only patients can partner with their primary care giver to make decisions which serve their particular condition best. Likewise, only patients can determine which form of insurance coverage best suits their unique situation. And only patients, behaving as individual consumers as they do daily other aspect of their lives, can refuse to pay for waste and unnecessary care; avoid doing business with those who perpetuate fraud and abuse; and determine for themselves which caregiver provides the best service at the lowest cost. Then and only then, when patients are equipped and enabled to behave as consumers, can we begin to see the health care system change.
Many would have us believe that shifting to a consumer centered model would be difficult. Nothing could be further from the truth. The individual U. S. consumer is the smartest, most capable being the world has even seen. The only difficult part is a willingness to equip patients to behave as “owners” of their own care and care decisions. Fortunately equipping patients needs not be overly complicated:
1. Patients must have access to information which is understandable and actionable. Today most individuals have access to better information about buying an automobile than they do about their own medical history or the cost and quality of their primary care physician. Interestingly enough the information exists and is accessible. Payers, providers, and even the government have access to the information most people need to make good decisions and become good consumers. That same information must be made available in a usable form for patients to equip them to make good “purchasing” decisions.
2. Every individual must learn to make health care decisions. Just as students in elementary school can learn math and science every individual can gain access to the education they need to understand health and health care. Much of what is needed is already available and in a form which can be understood by every patient.
3. Lastly, patients, like every other consumer, must be afforded the ability to speak with their wallets when they have made a “buying” decision. Today the constraints – both intentional and unintentional – prevent most patients from participating in many of the decisions about their own or a family member’s care. Once patients can freely choose from any payer, provider, and pharmacy we will begin to see the true power of consumerism and individual centered care.
Without question there is momentum to reform the system of health and health care today. But focusing on only one aspect – such as payment reform – and excluding the individual from the discussion and development of a new approach to health and care will be like moving the deck chairs on the Titanic. True reform can only be achieved when we empower individuals to behave as owners of their own health and health care.
Co-founder, President and CEO of Guidon Performance Solutions, LLC, Ron Wince has nearly two decades of experience leading performance improvement and cultural transformations within manufacturing, service and government organizations.
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