Health Policy Wit or Wit-Out Consumer Input

Dec 13, 2013, 10:56 AM, Posted by

Consumer advocates brainstorm about rising health care costs.

Whether you’re a Philadelphia native, a visitor, or just a cheesesteak aficionado, you need to know how to order. When you get to the front of the line at one of Philadelphia’s long-established cheesesteak stands you order your sandwich wit or wit-out. Either with onions or without. Whatever you do, don’t stand at the window and first think about this important decision. Let’s just say it won’t end well. But, as much as I love cheesesteaks (in moderation of course) this is not the most important wit or wit out decision we have to make as a country.

The decision we really need to make is how we want our health policy decisions made. You can have it wit or wit out consumer input. At a recent meeting on health care costs sponsored by the Robert Wood Johnson Foundation and Consumers Union, my colleague Anne Weiss drove this point home.

I’m paraphrasing a bit, but the gist of her remarks (and indeed of the meeting) was that efforts to contain spending and to get more value out of our health care system are going to come about with or without consumer input. She wants it to proceed with it. In other words, Anne’s ordering her health care value steak wit. I second her choice. Personally I think it’s ridiculous to eat a cheesesteak without onions, and I think it’s equally problematic to address health care costs without consumer input.

At this meeting, we worked to give consumer advocates the time, space, and background to think about how they might engage on the issue of rising health care costs. The meeting covered the basics of health care costs, the main drivers, strategies to address costs, examples from states that are working to address health care costs, and a lot of time for advocates to work together and identify key themes. You can find many of the materials from the meeting here.

If there is one overarching theme that I took away it’s that this is a complicated topic, but there’s no choice but to dive in. The U.S. spends $2.7 trillion a year on health care, yet we don’t have the outcomes we would hope to have. Even with recent slowdowns in health care spending, we know that the cost of health care is going to continue to be an issue for years to come. While there has been a lot of work to examine and address the issues, we need to do more to include consumers and the groups that represent them in this important conversation.

There’s no silver bullet, but it’s clear that addressing health care costs will involve a number of different tools: price transparency, health care delivery system redesign, payment reform, addressing population health status, and many others. Each of these areas for policy development can benefit from consumers being actively engaged and represented. Getting more value out of our health care system is the equivalent of turning an ocean liner around, and we need all hands pulling in the same direction. Consumer advocates play a valuable role in helping educate the public about changes to the system, how to be knowledgeable participants in their own health care decisions, and how to speak up when changes that are supposed to benefit them are harming them.

For all these reasons and more, we need our health policy decisions wit.

David Adler is a program officer on the Robert Wood Johnson Foundation’s Coverage team, and in the long-standing rivalry for Philly cheesesteak supremacy, David prefers Pat's.

David Adler / RWJF

David Adler, MPA, is a program officer for the Robert Wood Johnson Foundation working to increase the number of Americans with health insurance and improve the value the nation gets for its investments in health and health care. Read his full bio.