The Consumer as Advocate

by Joanna Smith on Nov 29, 2010

I was talking recently with a colleague in the healthcare advocacy world, and she was wondering aloud in puzzlement how people who did not have medical training could be healthcare advocates.  I laughingly said, ”We asked for it and we got it!”  The world of “consumer driven healthcare” has done exactly what I had anticipated:  it has put the consumer in the foreground of healthcare.  No wonder consumers are flocking to the field of healthcare advocacy!

In the not-so-long-ago world of healthcare, the focus was on moving to “consumer driven healthcare” where consumers–those insured by (primarily) employer-provided health insurance– were asked to start assuming more responsibility for the cost of their healthcare.  Their economic responsibility for their coverage was increased, and the “first dollars” of coverage often came from the consumers themselves before their insurance would move in with coverage.  The insurance companies believed their mantra:  consumers with more responsibility for their own healthcare would be more cautious and not utilizes as many services.

That strategy was partially effective, but sometimes in a counterproductive way.  Consumers delayed care; the cost “containment” came at the expense of the long-term goal of reducing costs:  if care is delayed, then the care eventually provided will cost more because of the delay. Did we save money?  That part is unclear.

But consumers, while delaying care, became highly informed consumers.  They researched their diagnoses on-line; they formed support groups; they started to contact physicians and researchers directly to find out more information on their particular condition.  They read about treatments and outcomes of clinical trials, and they became savvy consumers of healthcare.  And then they realized they could share information and be a support to each other; they could help others with similar conditions navigate the complex waters of healthcare.  In short, they became their own advocates, and then helped others do the same.

Click this link to see a funny (and serious) comment on this new world of the empowered healthcare consumer:

http://www.publicradio.org/columns/marketplace/money-blog/2010/11/the_too_informed_patient_in_th.html

So why are people surprised that consumers have gone into healthcare advocacy?  Consumers are smart, creative—and have the biggest stake in their healthcare future.  Insurers and employers said “accept more (economic) responsibility”; consumers replied, “If we’re paying for it, then we will be involved in many ways, not just economically.  We will no longer passively sit and accept what you tell us:  we can organize, inform ourselves and push for the care we want.”  That is the new world of consumer healthcare advocacy. Some of these consumers have opened practices where they assist others through healthcare systems. The thoughtful providers see consumer advocates as partners in the complex world of healthcare.

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