Enough talk.

Enough facts.

Something needs to be done, and it is up to you. Actually, it is up to us, but I am starting with you because you are reading this post.

Answer yourself this question – are you satisfied with the state of the healthcare system?

If the answer is yes, there is a high likelihood of one (or a combination) of the following (yes, these are gross over simplifications):

a) You have not been sick; or,

b) You have resources that allow for you to pay for what you need.

2007 Gallup polls indicated that the majority of Americans were satisfied with their healthcare. Aside from the fact that a whopping 1,004 completed this survey (and yes, the political powers that be made huge assumptions about national healthcare policy based on the opinions of 1,000 people), let’s dig a little bit deeper into why numbers like these are not indicative of a high quality healthcare system.

First, why isn’t satisfaction tied more to outcomes? We know that healthcare outcomes in this country are not on the same level as other countries in the world.

“Evidence that other countries perform better than the United States in ensuring the health of their populations is a sure prod to the reformist impulse. The World Health Report 2000, Health Systems: Improving Performance, ranked the U.S. health care system 37th in the world1 — a result that has been discussed frequently during the current debate on U.S. health care reform.”

So theoretically, one could be satisfied with healthcare and still have poor outcomes. One only knows what they know, right?

Second, just because we are satisfied with the healthcare system doesn’t mean that we personally are doing the right thing to take care of our own health.

In a recently published and often discussed article, Fenton et al. using 2000-2007 national Medical Expenditure Panel Survey (MEPS) data found:

“A satisfied patient is not a cheaper patient: however important such a finding may be in these budget-constrained times, that comes as little surprise. More unexpected is the finding that a satisfied patient is not necessarily a healthier patient — that the patient happy with the medical attention he or she receives from a physician is more likely to die than the patient who grumbles about it.”

We can be satisfied with healthcare, and still not take ownership over what they need to do. Said differently – “I can like you a lot, Dr. XXXX, and my liking you may not translate over into me actually doing things that are going to make me healthier. You tell me what I need to do, but rarely show me what I need to do. This makes it easier for me to not change, and your subtle encouragements are nice and not too threatening. I am satisfied with you and your care but may not actually work towards changing my personal health.”

So what can you do about this? What are some action steps to change healthcare?

1) Understand the importance of outcomes. When was the last time you asked your physician how they or their practice did on some health outcome compared to another provider or practice? While they may offer you advice or a prescription, how do they do at actually helping people have better health? These are reasonable questions to ask, but unfortunately few providers or practices know how they far against other providers or practices. However, you as the empowered patient should still try to find out (and ask!).

2) Understand your role in healthcare. Yes, it is ultimately all about you. While providers can be there to help you along the way, and fix things when they are broken, ultimately it is up to you to improve your own health. Go for a walk. Eat more greens. How will the healthcare system do this for you? It simply cannot. You have a role to play in healthcare too whether or not you admit it. Once we as a society stop seeing the healthcare system for only being about sickness, there will be a significant shift in our satisfaction of that system. We will notice that it does not do the things we need it to do to promote health. We will start to see our “sickcare” system for what it is – and not what we call it (“healthcare”).

So let me ask the question again – are you satisfied with the state of the healthcare system?