Health Care Consumerism and the Role of Legislation

[chandjohns86]

Health Care Consumerism and the Role of Legislation

Federal and state health care policies and legislation have a significant impact on the ebb and flow of health care utilization. Current trends suggest that rather than referring to people who utilize health care services as patients, it is more cost-effective to refer to them as consumers. By using this seemingly clever terminology, administrators hope to reduce health care utilization spending, believing that people will think in more detail before opting to use services. Though this may appear to be a good idea, it does raise questions as to whether this scheme is appropriate or misleading. The use of verbiage should be carefully weighed and evaluated to determine if it’s only purpose is to save money or if it intended to, truly, empower the people.

Federal and State Policies’ Impact on Utilization

For more than decades, those utilizing health care services have been referred to as “patients.” Recently, legislature has pushed to shift that term healthcare “consumers.” As the new term has been creeping into the embracement of the population, trends appear to be shifting, which only denotes the powerful nature that legislation can, and does, have on the trends of health care utilization.

If one were to consider consumer spending psychology, it has been countlessly suggested that prices ending in the value of .99 are more persuasive to buyers, depending on the setting (Chang & Chen, 2014). This type of psychological manipulation has proven to be extremely, though debatably, successful. In terms of health care utilization, when individuals view themselves as patients needing services, they will likely seek medical care; however, when individuals perceive themselves as consumers, they may be more selective and reserved in utilization of care (Pearl, 2015). This cautious behavior embodies the intentions of recent federal and state legislation efforts to reduce healthcare costs and, so far, it appears to be working (Hempstead, 2014). This slowdown in utilization is likely a trend that, so long as the term “consumer” and “consumer-based” health care persists, will result in a continued slowdown of service utilization. The slow-down in utilizing health care services demonstrates just one example of the incredible power legislature, both state and federal, have on the healthcare market.

Efficient or Manipulative?

By identifying a patient as a consumer, he or she may question whether they really need medical care at any given time. This could be a significant barrier in seeking critical treatment because cost, versus need, has now been brought to forefront thought. Consumer thinking can have devastating effects to individual’s health statuses, leaving them vulnerable in instances where medical intervention was necessary as they debate financial losses over seeking treatment. Although the use of different terminology is not a crime and as such has resulted in lower spending, ethical questioning should be considered in the potential consequences of this tactic.

Conclusion

Although it is important to control healthcare spending, careful consideration is needed when confronted with the present underhanded push to reduce utilization. Instead of using terminology that hinders an individual’s already depleted sense of power over their health, alternative methods of deterrence are in order, such as better utilization of gatekeepers and referrals for services. Through these different means, although it would result in more time to receive the necessary health care, it would still prevent overutilization, socialized medicine, and disempowerment of the patient.



References

Chang, H., & Chen, F. (2015). When is a 9-ending price perceived lower than a 0-ending price? The moderating role of price consciousness. International Journal of Business and Information, 9(1).

Hempstead, K. (2014, September). Early trends in health care utilization in the commercial market. Robert Wood Johnson Foundation.

Pearl, R. (2015). Forbes.

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The above is an assignment and we were encouraged to post on a message board, so here I am. Fire at will.

 

[dblack]

The wordsmithing of regulators doesn't bother me as much as the apparent premise that we should be using government to control health care in the first place. Was that given to you as part of the assignment, or is it your own assumption?

 

[chandjohns86]

Well, the point was that the government already regulates health care, especially public health care. (To stay under "word count" there were several segments that had to be removed, and in the end, I really didn't like how this stupid report turned out anyway.) In answer to your question, it was not an assumption; the information provided is supported in the writing based on research and class materials. Legislation has pushed to change the word "patient" to "consumer" and as such, people are behaving differently in terms of healthcare utilization. Assuming that regulation will continue to be maintained by the government and other entities (think OIG), then yes, there are other means to doing it. Ideally, if government / legislative regulation persists, which it will, then health care costs should be controlled, which will, in turn, result in lowered health care spending (in theory). In my opinion, a major driving factor in the need to control costs is because healthcare has been one of the fastest rising expenses with the third lowest satisfaction rate. People need health care, but health care needs to be regulated, and cost/spending is definitely one area that should be regulated, especially considering the low satisfaction and low positive outcome rates. You wouldn't run to the grocery store and come home with an expired product and just use it (or maybe you would, but I suspect the vast majority of people wouldn't).

 

[dblack]

Well, the point was that the government already regulates health care, especially public health care. (To stay under "word count" there were several segments that had to be removed, and in the end, I really didn't like how this stupid report turned out anyway.) In answer to your question, it was not an assumption; the information provided is supported in the writing based on research and class materials. Legislation has pushed to change the word "patient" to "consumer" and as such, people are behaving differently in terms of healthcare utilization. Assuming that regulation will continue to be maintained by the government and other entities (think OIG), then yes, there are other means to doing it. Ideally, if government / legislative regulation persists, which it will, then health care costs should be controlled, which will, in turn, result in lowered health care spending (in theory). In my opinion, a major driving factor in the need to control costs is because healthcare has been one of the fastest rising expenses with the third lowest satisfaction rate. People need health care, but health care needs to be regulated, and cost/spending is definitely one area that should be regulated, especially considering the low satisfaction and low positive outcome rates. You wouldn't run to the grocery store and come home with an expired product and just use it (or maybe you would, but I suspect the vast majority of people wouldn't).

The bolded portion is the assumption I was referring to. In my opinion, state manipulation of the health care market is the problem, not the solution.

 

[chandjohns86]

The bolded portion is the assumption I was referring to. In my opinion, state manipulation of the health care market is the problem, not the solution.[/QUOTE]

I completely agree with you, hence my original notion that the tactic is underhanded. (We aren't allowed to outright say it's bull crap in the assignment, so I have to be choosy, especially with this instructor). But yes, the industry needs to be regulated. Since various government bodies already monitor the public health sector (Medicaid, Medicare, VHA, etc.), there's no reason why the limitations of reimbursement placed on these beneficiaries shouldn't be expanded (at least a little bit) across the market of providers. There are holes in each method of effort to control health care costs, so there's not an easy answer. Everyone sees different holes, some mutually common and some arguable. The bolded text you are referring to is a combination of opinion and assumption. The opinion is that cost needs to be regulated, the assumption is that it will continue to be regulated.

 

[Cecilie1200]

The bolded portion is the assumption I was referring to. In my opinion, state manipulation of the health care market is the problem, not the solution.

I completely agree with you, hence my original notion that the tactic is underhanded. (We aren't allowed to outright say it's bull crap in the assignment, so I have to be choosy, especially with this instructor). But yes, the industry needs to be regulated. Since various government bodies already monitor the public health sector (Medicaid, Medicare, VHA, etc.), there's no reason why the limitations of reimbursement placed on these beneficiaries shouldn't be expanded (at least a little bit) across the market of providers. There are holes in each method of effort to control health care costs, so there's not an easy answer. Everyone sees different holes, some mutually common and some arguable. The bolded text you are referring to is a combination of opinion and assumption. The opinion is that cost needs to be regulated, the assumption is that it will continue to be regulated.[/QUOTE]

I would have to question the apparent assumption that there's something wrong with encouraging people to think and make decisions about whether or not they actually need medical care at a given moment, as though healthcare should for some reason be exempt from the cost/benefit analyses we make every day of our lives on every single other topic that ever comes up.

Seems to me that anything that moves people toward being active participants in their own health and medical care, rather than passive recipients of others' activity is a good idea.

 

[dblack]

I would have to question the apparent assumption that there's something wrong with encouraging people to think and make decisions about whether or not they actually need medical care at a given moment, as though healthcare should for some reason be exempt from the cost/benefit analyses we make every day of our lives on every single other topic that ever comes up.

Seems to me that anything that moves people toward being active participants in their own health and medical care, rather than passive recipients of others' activity is a good idea.

I have more general objections to the notion of government "encouraging" anyone to do anything. First of all, It's a euphemism. Government doesn't encourage. It passes laws and enforces them. It mandates consequences for not following the law. Second, regarding the OP, simply playing games with the language won't have a lasting impact. Calling patients consumers instead won't change the core dynamic. The problem isn't that patients don't understand that they are consumers. The problem is that they are insulated from the value decisions that consumers typically make. The vast majority of health care consumers are either insured, in which case they don't really care about their health care costs, or they are relying on another third party to pay the bills (government, charity, etc...), and don't really care what their health care costs.

If the government wants patients to behave more like consumers, they need to get rid of the policies that have enabled them to behave otherwise.

 

[Cecilie1200]

I would have to question the apparent assumption that there's something wrong with encouraging people to think and make decisions about whether or not they actually need medical care at a given moment, as though healthcare should for some reason be exempt from the cost/benefit analyses we make every day of our lives on every single other topic that ever comes up.

Seems to me that anything that moves people toward being active participants in their own health and medical care, rather than passive recipients of others' activity is a good idea.

I have more general objections to the notion of government "encouraging" anyone to do anything. First of all, It's a euphemism. Government doesn't encourage. It passes laws and enforces them. It mandates consequences for not following the law. Second, regarding the OP, simply playing games with the language won't have a lasting impact. Calling patients consumers instead won't change the core dynamic. The problem isn't that patients don't understand that they are consumers. The problem is that they are insulated from the value decisions that consumers typically make. The vast majority of health care consumers are either insured, in which case they don't really care about their health care costs, or they are relying on another third party to pay the bills (government, charity, etc...), and don't really care what their health care costs.

If the government wants patients to behave more like consumers, they need to get rid of the policies that have enabled them to behave otherwise.

That's all quite true.

However, I would like to point out that conservatives have been using this exact linguistic tactic for a while now, pointing out that patients are the healthcare CONSUMERS, but they are not the healthcare CUSTOMERS, and therefore not the people whose priorities the providers are trying to meet.