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December 09, 2008
Is Leadership--and Not Consumer Choice--the Answer to the Healthcare Crisis?
By Catherine Moreton Gray

The healthcare crisis is a leadership problem and not a consumer problem, according to James Clifton, Chief Executive Officer of Gallup, Inc. “We must have a system that forces people to think and act differently,” he said. If we think it’s a problem that we can fix by giving consumers more choices, “we’ll go broke.”

Clifton opened The National Conference on Health Care Consumerism in Arlington, Virginia on December 9, 2008, with his keynote address titled “What Do Consumers Want From Their Healthcare?”

Individual consumers are concerned about the present, said Clifton. “If you ask consumers what they want from their health care, the answer will be everything.” When it comes to their loved ones, people generally want to keep everyone alive as long as they can regardless of the cost, and usually the cost is covered by insurance or the government, he said.

According to Clifton, the cost of health care in the United States is currently around 2.2 trillion dollars and this number is on track to double in the next 8 years. Healthcare costs are growing, and the potential affect on our economy as well as the world economy is huge. In fact, Clifton suggests it could cause bigger problems than were caused by the sub-prime mortgage meltdown we are experiencing now.

Clifton states that this is a behavioral economic challenge. We need to address the consumer state of mind and our leaders will have to do it through policies. Clifton reminded conference attendees that in his lifetime, more than 40% of the population smoked, littering was commonplace, and very few people wore seatbelts when driving. However, through policy changes, laws, and information campaigns, things have changed drastically. Now, only 17% of the population smokes and the majority wear seatbelts. Littering has decreased and is no longer generally accepted. Clifton says the same must happen with health care—we need to focus attention and energy on “health and wellness, and less on sickness intervention.”

Clifton also suggests that consumers are thinking short term and aren’t likely to make the lifestyle changes necessary over the long term to maintain health and wellness. This is where leadership is critical and policies must change to change consumer behavior. “We must have a system that forces people to think and act differently” said Clifton.

In a poll conducted by Gallup, Inc., Clifton notes that individuals with a higher sense of well-being are more likely to keep themselves healthy. The poll results indicated that only 25% of the workforce has a strong sense of well-being and 20% are what the pollsters refer to as “actively disengaged”—miserable and actively trying to get others to join their ranks. Clifton suggested that if companies could double the number of employees with a strong sense of well-being, we could significantly decrease healthcare expense.

Clifton also noted that approximately 70% of the 2 trillion dollars of healthcare expense is incurred during end of life care when we want to keep a loved one alive, even one more day, at any expense. He suggests that we need to “change our relationship with dying” and at the same time leaders need to implement policies that encourage people to get and stay healthy.

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