We’ve all heard this one.  When asked about Congress or our state legislature, voters give low performance ratings to both followed by, “but my representative is a good guy.”  It would seem that the same holds true about constraining the growth of health care costs.

We will spend about $2.7 trillion on health care this year, close to 18 percent of our nation’s gross domestic product.  It’s  a metric that will surely hit the 20 percent mark before this decade is over, and a number that could reach 25 percent by the middle of the next decade if the cost containment measures in the federal health care reform laws fail.  Most analysts would say that this is an unsustainable future for our economy, and one would have to go long and far to find a consumer who either loves the size of his or her health insurance premiums or approves of a health care cost inflation rate that often equals or exceeds three times our overall inflation rate. 

Yet, despite efforts by employers and insurers to engage consumers in helping to bring down costs in health care, a study published in a recent edition of Health Affairs found two important factors: Its focus group participants did not generally understand how insurance works, and they felt little responsibility for helping to solve the problem of rising costs.  Moreover, they were unlikely to accept a less expensive, equally effective treatment option. 

The study also revealed that consumers do not want physicians to consider patient finances when they make treatment decisions. And  if they have insurance, they not only feel entitled to the more expensive care, they see it as an opportunity to “stick it” to their insurance company.

This was a small study, one that certainly should be replicated and further validated. But the question remains—how do we change the health care cost paradigm if the consumer refuses to engage in the change effort?  This predicament reminds me of what Winston Churchill said about politics:  “The best argument against democracy is a five-minute conversation with the average voter.”

Your thoughts?