The Problem With Consumerism in Health Plans....

Confrontation is tough for many, many people... I was talking to an employee last week about being an educated consumer of healthcare and the convo went like this:

Me - the whole key with controlling your prescription costs is to do a couple of things - first, always ask your doctor for the generic and have dialog with him/her that your outcomes will be the same.  If no generic is available, go to the next step and tell your doctor you have a tiered Rx plan that includes Preferred and Non-Preferred. and ask them to look up the Caremark Performance Drug List and see if there is a prescription they can provide you that is on the Preferred list.

Employee: Preferred and What?

Me:  Preferred and Non-Preferred (followed by brief explanation of the difference).

Employee:  Isn't that the doctor's job?

Me:  Sure, but if you don't engage them and ask, you're going to end up having to pay more.  So, you'll want to ask...

Employee - Can I really do that?  It's kind of hard to ask them for specific things since they are the expert...

I'll spare you the rest, but that's a great primer on the problems with consumerism. First up, as commenters on this site have noted, we are many years away from true price/effectiveness transparency in our health-care system.  But bigger hangups also exist as noted by my conversation above - namely employees are loathe to engage their doctors on topics key to consumerism - price/effectiveness trade offs, alternative treatments, etc.  The subject matter expertise of the doctor intimidates at least 50% of employees in my experience, so much so they can't bear to ask questions based on their perception of the knowledge gap between themselves and the doctor.

The Seinfeld clip below puts it all in perspective.  If heath care end-users are confused by the over the counter situation (and they/we are), then how can they aggressively engage the doctor to find the right cost/benefit mix for any higher-end item of health care? 

Consumerism is confrontation.  Mix in the "expert" power of the doctor or pharmacist, and most people would rather make a call on medication based on what the doctor says first, without asking questions.  Or make a call on a over the counter medication based on where it was made (Jersey vs. White Plains, anyone?)...

Comments

[Michael Wolfe]

That's the perfect clip for the post...Thanks!