Deloitte puts out a survey updating its work on global consumer attitudes and trends relating to health care. (Deloitte Survey) The countries included in the survey include Australia, Canada, Denmark, Germany, Singapore, England and the Netherlands, in addition to the US. Supposed “consumer” behavior in health care includes being informed, evaluating choices and acting independently. These attitudes would be reflected in being proactive about health and preventive care, willingness to disagree with a clinician, willingness to change doctors or plans, and of course using technology, data, digital tools, etc. The survey finds, as you would expect in a world where people are bombarded with sales pitches for wearables, mobile apps, and so on, that an increasing number of consumers are interested in or using these. 53% of respondents in the UK, for example, said they measure their fitness levels and set health improvement goals. Without belaboring the specific results of the survey, I am sure it is true that people are collecting more health data, are more willing to share it, are using health apps of various types, are more interested in virtual visits (which I do believe have value as they should improve access and reduce unit prices), willing to compare providers on price and quality and willing to disagree with or at least discuss the direction of their health care with providers. All that may be true but so what? This report and others constantly claim that this will revolutionize health care.
I know there is a class of consumers who are fairly active in monitoring and advancing their health status. These people were going to be healthy no matter what and frankly they don’t need health insurance, it is a waste of money for them and they are subsidizing others who don’t care as much about their health. No data or tool is going to stop hospital consolidation and price increases or keep drug companies from charging absurd prices for their products. The small part of the population that accounts for a ton of spending isn’t going to be helped by mobile apps or big data or predictive analytics or any of that nonsense. It is generally too late. What can reduce some spending on that group is intensive personal management of care, which can avoid hospitalizations and other expensive utilization. That kind of care management is expensive. I don’t care what any consulting firm says–show me the evidence that all this supposed “consumerism in health care” makes a real difference in spending, utilization or people’s actual health status, then I be will a little less skeptical about the value of all these hot-shot tools, analytics and data. The reality is reflected in the regular reports on national health care spending, like the one we reported on in Monday’s post, which show absolutely no effect of all these supposed advances in consumerism in health care.