Consumers grow allergic to health care costs

Lower use of health care by consumers in recent years is unusual, since health care used to be known as a recession-proof industry. But a recent survey by the Deloitte Center for Health Solutions suggests that not only are health care consumers price-conscious, they’ve become increasingly so in just the last two years.

Deloitte surveyed 4,000 Americans in April, asking mostly the same questions as in previous years' surveys. The results were released in July.

The consulting firm found that 20 percent of consumers have cut back on health care spending and 75 percent say the economic slowdown has had some impact on their willingness to spend on health care.

One in four patients had delayed care for an illness or injury and of those, half said they did so because the cost was too high. In previous years, only about 35 percent cited cost as a reason they delayed care.

About 18 percent of consumers have no designated primary care physician, with more than one-third of those saying they can’t afford one. In 2009, only one-fourth said a primary care doctor was unaffordable for them.

One out of five patients has now used a retail clinic, such as MinuteClinic, and the same proportion use natural, homeopathic or alternative therapies in addition to the traditional health system.

Roughly two in every five patients have asked their doctor to prescribe a generic drug instead of a brand because of cost reasons. And the same proportion of patients has switched a brand-name prescription to a generic because of advice or a cost comparison given by a retail pharmacist.

Among health insurance customers, 82 percent now list the cost of premiums as their number one consideration when choosing a plan, up from 73 percent two years ago. The cost of a doctor’s visit is as important, being cited by 81 percent of customers.

And among consumers who switched insurance plans last year, 33 percent say they did so in order to pay less, up from 23 percent two years ago.

“Rising health care costs and the recent economic downturn are prompting consumers to scale back, skip care, and consider non-conventional options,” wrote Paul Keckley, executive director of the Deloitte Center for Health Solutions, along with co-authors Sheryl Coughlin and Laura Eselius.

Also, interestingly, consumers in Deloitte’s survey overwhelmingly reject the main notion that was used by President Obama to argue for his health reform plan and is now the rallying cry of the accountable care movement among hospitals and doctors: namely, that it is possible to improve quality and reduce costs simultaneously in the current U.S. health system. Fifty-five percent of respondents disagree, with fewer than 10 percent agreeing.

“U.S. consumers recognize that the health care system is costly, confusing, and delivers suboptimal service and value,” Keckley concluded.