Early this spring, we decided to conduct a national online research survey to find out exactly what everyone needs us to do, and whether or not a membership website would fly.  The reality is that we have to figure out how to pay the bills while we’re doing something to help patients.  Investors want to see that you understand your market and have a business model that will work before they’ll put money into it.  So we’re forced into planning, and being very business-like about our company.

During our research, we talked to people in Chicago and Houston who were underinsured and uninsured.  They also used the Internet and had at least one ongoing health condition.  I’ve done tons of consumer and patient research over the years, but this time the thing that really struck me was just how mad everyone is!  I’ve heard frustration in the voices of patients and families for years.  Mostly, it was around how clunky our system is or how distant patients felt from their doctors.  Today, the rage is over costs.  Everyone has a story about how much their medical bills are – even those people who don’t have life-threatening illnesses. It was more amusing when our insurance coverage covered the cost of the $500 aspirin in the hospital.

For those we spoke to who had health insurance, many were underinsured and left with large out-of-pocket expenses when they or a loved one got sick.  It won’t surprise any of you, but many patients railed against insurance companies and how oblique they are about what is covered. And of course, many people talked about how they couldn’t afford coverage unless they had high deductibles and then were vulnerable to financial ruin.  We heard a lot of fear in everyone’s voices.

As our focus group members talked about losing insurance due to job losses, many of them referred to their old insurance cards as the gold card.  They talked about the status you have when you’re insured versus being uninsured.  According to some, there are doctors who don’t want to care for uninsured workers because they’re afraid of bad debt.  And private hospitals often send you to the county hospitals as fast as possible. But mainly people talked about going without any type of care at all, and how bad they felt about not having health insurance.

There are more than 133mm U.S. adults who suffer from a chronic health condition.  Not all chronic conditions are alike, however, some require more maintenance and doctor-patient connection than others.  But the term chronic condition means you’re going to live with your illness forever, or at least until there’s a cure.  We certainly have the choice of not getting care, or even caring for ourselves, but for those of us who want quality living, it means taking over the driver seat to manage our treatment and the cost of that care.  One step is to dig in and find out how much your treatment plan will cost before you agree to the tests and medicines your doctor orders.  It may be uncomfortable at first, but remember you’re the one responsible for the bill.

The term healthcare consumer has been emerging for a decade now.  Historically, in health we consume without really understanding how much things costs.  Now we need to be purchasers as well as consumers, so it’s time to step up.

The best part of listening to people in our focus groups was the amount of sharing, tips and support everyone gave each other.  There are ways to lower medical bills and not sacrifice quality healthcare, but unfortunately, we haven’t gotten real lessons in how to do this.  The only thing being touted by health insurance companies is to go with generic versus branded drugs, which may be a quality issue if the generic doesn’t do the trick.  I’m pretty sure you’ll agree — it’s time to pull into the driver’s lane and take control of both our physical and financial health.

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