The three goals of the American health system are often stated to be good access to care, good quality outcomes and lower spending. Depending on your socio-economic status, we seem to have mixed results on all three. I tend to think that getting and keeping people in good health is the most important goal and a recent survey from West’s Televox division deals with patient and provider perspectives on that issue. (West Survey) Starting with the obvious, almost every consumer believes our system has serious issues. 43% say they are frustrated with the system, 38% say they are disappointed, 29% are stressed by it and only 13% say they are happy. 85% of provider respondents and 85% of patients said that they are paying an excessive cost for the quality they get. About 40% of patients say quality is one of the biggest issues with health care and 65% say quality is an important concern when they select a provider. 83% of patients say their providers are responsible for the health status, while 96% of providers are frustrated by patients not taking enough responsibility for their health. In general, though, people don’t seem to perceive their health is getting better or worse, as 60% say their health stayed the same over the last year, 20% say it got better and 20% say it got worse.
At least patients have some awareness of their responsibility; as 53% of those who said their health got worse acknowledged that they did not exercise enough, 42% said they didn’t get enough sleep and 39% said poor diets contributed to their health decline. These people who said their health worsened also were often not aware of all the preventive and wellness services which might be available to them, creating a provider and payer opportunity for better education. Patients expect providers to proactively help them with lifestyle changes, including by advice, encouragement and reminders. Technology can help by automating and customizing messages to patients. Providers are obviously aware of the patient concern about quality, as they spend a lot of money trying to create brand images of quality; money that probably could be better spent actually improving care, or even just lowering prices. And while people’s health status should be the main goal of the system, it is harder to reach that goal when the cost of health care deters people from seeking it when they should. And if people don’t have some financial pain when they need health care in part or in whole because they weren’t responsible about health behaviors, they are far less likely to engage in those good behaviors. So we have a very tricky set of issues to navigate.