By Michael Painter, MD
“‘Let’s go.’ ‘We can’t.’ ‘Why not?’ ‘We’re waiting for Godot.’” â€• Samuel Beckett
For the economists in our midst, demand is a critical but pretty dry idea: the quantity of a good or service a buyer is willing to purchase at a given price. It’s presumed to be part of working health care markets.
It’s one of the first things an undergraduate might learn in Econ 100.
There’s no urgency in this demand; it just is.
Of course, nothing—even general economic principles—is simple in health care. Still, you can look longingly at a few nice supply and demand curves and dream about how things might be—if only.
If only health care consumers picked up their role and skittered up and down those demand curves.
If only they helped us find those elusive market equilibriums for this health care service or that. For some time, lots of people have seen that enormous and powerful potential—and drooled over it.
We’ve been waiting a long time for our consumer to show up in health care. We’ve been waiting for the consumer to obtain and use the information she needs to demand great care.
We’ve been waiting for lots of consumers to do that over and over to help us out of our unfortunate health care jam.
It’s that jam where we pay too much for lots of care of marginal quality riddled with safety problems and delivered by a bunch of dissatisfied, demoralized health professionals.
Indeed we have been waiting a long time for our health care consumer. Certainly, there have been and continue to be countless reasons why consumers haven’t arrived to help save us.
“Health care is different!”
“There’s no evidence that consumers will behave like normal consumers in health care!”
“Consumers don’t have quality information!”
“There’s no price information in health care!”
“They don’t have an incentive to use information to make the best decisions!”
There is a long and disturbing list of reasons why consumers don’t arrive. Because of that, one is rightly skeptical when people say that things are different now.
Consumers are ready. The information is coming online. Direct care costs are piling up on the consumer, forcing her to behave differently than her mother or grandmother might have.
Many of those observed changes are happening though; that part is true.
Because of that, many strongly believe that the consumer’s time is upon us. In fact, there are a number of groups trying to midwife a new consumer movement.
Case in point: the folks at HCI3 whose mission is to shape health care incentives that will help drive efficiency and value. They’ve created a worthy, credible website, INQUIREhealthcare. HCI3 targeted this site at our now-ready consumers—those folks we’ve been waiting on all these years.
The new site has numerous tools that can help consumers choose high-quality providers, become more engaged in their care and help change health care by starting a local grassroots movement calling for more price and quality transparency.
There’s something else here too—a sense of urgency. The site urges consumers to abandon complacency—to tell their stories, use the tools for themselves and their families, get informed, get involved, and become part of something big. I like that very much.
Another definition of “demand” isn’t quite as dry as the economist’s. Demand is also an urgent request. The individual making a real demand doesn’t just kind of want something at a given price—she wants it really badly, and she wants it now.
That imperative, like this new consumer website, would definitely be refreshing. At least it would be if our consumer finally arrived.
Ready? Wait for it…
This post originally appeared here on The Health Care Blog on February 5, 2014.