"Health 2.0" vs. Consumer Apathy

(MoneyWatch)  The notion advanced by enthusiasts of "Health 2.0" is both simple and appealing. A new generation of interactive Web services, they say, will arm individuals with data, tools and supportive online communities so they can take charge of their own medical care -- and in turn transform the broken U.S. healthcare system from the bottom up by demanding better service and lower costs.

Which is all fine and wonderful but for one thing: What sort of revolutionary effects can you really expect if many people don't want to -- or simply can't -- empower themselves this way?

A common response -- one I heard several times at a recent Health 2.0 gathering in San Diego -- is that there simply won't be many such people, because the benefits of tracking and managing your own health the way you might day-trade stocks or restore an antique car are just too great to be ignored. In fact, though, it may be the self-actualized, Web-empowered medical consumers who find themselves in the minority.

Over at the Health 2.0 Blog, appropriately enough, healthcare analyst Brian Klepper recaps some of the latest data on the subject based on a recent talk by Kaveh Safavi, the chief medical officer of Thomson Healthcare's Solucient analysis unit. It's sobering indeed for the folks expecting Health 2.0 to launch a consumer-driven healthcare revolution.

The slide at right (click for a larger image), for instance, shows that such "quality-driven" individuals -- defined as folks who would both look up ratings information on doctors and hospitals and then act on it by switching to a better-rated care provider if necessary -- make up just 19 percent of the adult U.S. population. A full third simply go with the flow, neither researching nor changing, while almost two-fifths would change providers, but for reasons having nothing to do with quality ratings (this latter group, Klepper notes, might as well be nicknamed "Ignorance on Fire"). Unsurprisingly, quality-driven consumers tend to be older and wealthier than the general population.

While these figures may well shift over time, the obvious conclusion in the short run is that empowering consumers only gets you so far in terms of driving systemic healthcare change -- the rest is up to many of the very institutions responsible for the healthcare mess in the first place. Which, however, is not entirely bad news, at least as Klepper sees it:

[T]he subtext of this information is undoubtedly that the most important changes coming in health care will occur not only in the ways that consumers get and act on information, but in the ways that organizations - health care and non-health care businesses - do. Even though health care information can have serious utility for individuals, many of us simply don't appear to be built to chase and use it. Businesses are different though. Most are based on a discipline of following through, and they succeed or fail on their ability to use information effectively.

I hope he's right, and to be sure, there are already a few instances of Health 2.0 startups like Healthline aiding health plans like Aetna in offering more personalized services to their members. I'd expect to see more deals like that going forward, and how they fare will tell us a lot about what we can really expect from health-related Web services in a global sense.

The Solucient data also has important ramifications for "consumer-directed healthcare" -- the notion that making individuals responsible for their medical expenses, usually with some help from health-savings accounts and high-deductible insurance plans, will fix the ailing healthcare system via the magic of market competition. Whether or not you think this is a good idea (I'm a skeptic, myself), surely a consumer-driven system would require the engagement of more than 19 percent of the population to even have a shot at living up to its promise.