It seems like every time we turn on the news, we hear that health care costs are out of control, but most of us feel that we are unable to stop the speeding train. Our American mindset tells us that more is better, and this seems to carry over to health care as well. However, that is simply not realistic. A recent article, published in Health Affairs, outlines the challenges surrounding getting patients involved in their health care cost decisions. Although the study was not scientific, the researchers questioned twenty-two focus groups about their perceptions of health care costs and what (if any) role they feel they play.
Only the best will do
For most people, health is their number one priority. As the old saying goes, “If you don’t have your health, you don’t have anything.” Unfortunately, patients blindly believe that the most expensive care must be the best. In this study, when provided with two types of care (and even when told that the cheaper option was “good enough”), patients viewed the more expensive option as better. Often times, patients choose the more expensive option because they think it guarantees that nothing will be missed and that they will receive the best care. Since they have insurance, and they will not be paying the bill, the cost of the care is not factored into their decision-making process. As a society, we recognize that health care costs are a problem and we want to fix it, but as individuals, we are not willing to let go of what we “think” we need. When it comes to our own health care, only the best (most expensive) will do.
The link between health and money
Just as most patients only want the best, they also don’t often think about how finances and health affect one another. While many doctors agree that financial problems can have a negative impact on patients’ health and wellbeing, participants in the study viewed health and finances as separate issues. And just as a poor financial situation can bring about poor health, the reverse can also be true. Poor health creates poor finances. Although many serious illnesses are preventable, people ignore their health and then don’t have the money to pay for the future consequences resulting from poor health. The best way to avoid ending up with poor health and finances is to focus on wellness and preventive care. These visits and services are much more affordable than the long-term care that is needed for chronic conditions.
It’s not coming out of MY pocket
The reality is that most patients don’t believe they bear any responsibility for our financial health care crisis. Their thought is, “I didn’t get us in this mess, so why should I help solve it?” Participants in the study even had negative attitudes toward the insurers and the government, and felt that choosing higher-cost care options was a way to “stick it to the man.” After all, many Americans pay for health insurance so that they don’t have to worry about the cost of their care. Unfortunately, this mindset won’t get us anywhere, and surely won’t solve the problem.
So what can we do?
As primary care providers, we feel it is our duty to play an active role in managing health care costs. We encourage our patients to get involved in their health care and make choices that are both medically and financially sound. One solution is the“Choosing Wisely” campaign. This effort by the ABIM Foundation and Consumer Reports aims to educate physicians and patients about unnecessary tests and treatments. They have identified multiple procedures and treatments that are not effective and create needless spending. The goal of the campaign is to educate the public and physicians, and ideally reduce the amount of money that patients, insurance companies and the government spend on unnecessary care options. Read more about how we’re practicing “Choosing Wisely” here at SFM.