The Health Care Consumer’s Manifesto

How to get the most for your health care dollars.

Americans love to shop: for gadgets, airline tickets, new outfits, the latest smart phone. We love the act of shopping almost as much as the goods themselves, especially in the digital age. The Internet lets us shop from home, on the road, at the coffee shop. When we need to, we are also willing to shop for less fun things, like mortgages and car insurance. Why, then, don’t we shop for health care? 

Each year, Americans spend nearly a trillion dollars – and rising – out of our own pockets on health care and insurance. Yet even as money flows out, we scarcely recognize our roles as health care consumers. People spend more time shopping for furniture, home repairs, and even groceries. 

But we all eventually need health care, and increasingly, we pay a significant portion of the cost burden ourselves. Shouldn’t we get what we pay for? Why do Americans pay so much for health care and get so little? Why don’t Americans demand to know the price of health care services before we get them? Why don’t we find the energy to fight erroneous bills, or open mail from our health insurer with confidence and resolve rather than dread? Why don’t Americans expect good customer service in health care settings, or negotiate a refund if what we buy doesn’t work? And what might happen if we did? 

Health care is complicated. It’s stressful. It’s expensive. And consumers face massive disadvantages: we can almost never know more than our doctors about what we need, and we often face decisions at our most vulnerable moments. Sick, scared, or confused, we feel like we don’t have any choices at all. In health care, many of us lack competence, confidence, or even the imagination to consider ourselves agents in health care purchasing decisions.

Deb Gordon’s research as a Senior Fellow at the Harvard Kennedy School’s Mossavar-Rahmani Center for Business and Government, informed by her experience as an executive in the health care industry, bucks conventional health care wisdom that consumers can’t and won’t shop for health care; that it’s too different from other goods and services we normally buy. Her work suggests people can – and sometimes do – shop for health care, though too few realize it’s possible, and those who do often bump into real obstacles to capturing value for their health care dollars. Deb imagines a health care consumerist movement, in which consumers use purchasing power to help shape a new kind of health care market, one that puts consumers first. 

In The Health Care Consumer’s Manifesto: How to Get the Most for Your Money (Praeger Publishing, on sale February 29), Deb navigates and demystifies the confusing and frustrating world of health care shopping. She takes readers on a guided tour inside American health care, revealing why health care is so messy, and who is invested in keeping it that way. She offers a new vision of how health care could work if it were truly designed to meet consumer needs, and calls us to action on how to demand – and thereby help create – such a system. 

A wake-up call to an industry tenuously holding on to the status quo and ripe for true disruption, this book outlines what consumers can do themselves and demand from doctors, hospitals, health plans, and policy makers to get more for their health care spending and in so doing, reshape the health care system into one we all deserve.