Several new studies reveal that more patients are feeling and living out their role as health care payors as medical spending vies with other household line items. This role of patient-as-the-payor crosses consumers’ ages and demographics, and is heating up health care as the top political issue for the 2020 elections at both Federal and State levels.

In research from HealthPocket, 2 in 5 Americans said they needed to reduce other household expenses to be able to afford their monthly insurance premiums. Four in ten consumers said their monthly health insurance premiums were increasing. One in four people in the U.S. was unsure about their premium, which is a group of people who isn’t yet health-engaged as payors.

In this poll, the two top-noted issues for the upcoming President election were the economy (identified by 27% of Americans) and health care (for 25% of Americans), followed by taxes and education (each at 14% of consumers.

Wolters Kluwer released a summary of a study this week, to be published in full in 2020, surveying 1,000 consumers (232 of whom had been a hospital inpatient in the past year) and 837 health care providers (a mix of physicians, nurses, and hospital administrators). The summary’s title tells you the focus of the research: Mending Healthcare in America 2020 – Consumers + Costs.

The second chart comes from the Wolters Kluwer research, illustrating the consumer-patient “drop-off” of prescription drugs due to costs and other factors. The top-line first big number is that 52% of patients do not fill a prescription due to the cost of the medication. Another near 1-in-2 people don’t take their medicines as prescribed — perhaps splitting pills, skipping doses, and other mis-use. Fully one in three people stop taking a medication before the therapy was prescribed to end.

Other key findings relating to “consumers and costs” in the Wolters Kluwer survey were that,

  • 4 in 5 physicians and nurses agreed that the patient’s cost influences what treatments the prescribers recommend
  • Consumers make personal clinical decisions that can be against “doctor’s orders” and shop for health care at another provider site that can be less costly and/or have better consumer reviews or word-of-mouth (with 4 in 5 consumers traveling past the closest hospital to one further away due to a better reputation)
  • One-half of consumers believed their greatest medical risk is self-rationing prescription medicines due to cost (per the second illustration), and
  • Millennials are twice as likely to self-ration Rx due to cost (61%) versus Baby Boomers (31%).

Health Populi’s Hot Points:  In addition to these two consumer studies, we can add to this context the latest read on the U.S. Consumer Price Index which was published by the Bureau of Labor Statistics last week. BLS calculated that general price inflation rose 1.8% on an annual basis as of October 2019. Costs for medical care services (hospitals, ambulatory care, doctors, dentists, vision) bundled together grew 5.1% in the 12 months including October 2019. Health insurance costs increased a whopping 20.1% in the year to October 2019.

Health care costs are now integrated into national and state politics in America. The last chart here is Wolters Kluwers’ take on U.S. health politics looking toward November 3, 2020.

Today, health care as a political priority cuts across all generations beyond older Americans, beyond Medicare.

“Consumers will head to the polls with healthcare in mind,” the Wolters Kluwers team forecasts. Their summary report coined four lenses on U.S. health consumer-voters, shown here. Taken together, it’s a kind of majority vote for health care at the polls looking at overall health care structural reform, health care costs (as expressed by premiums and deductibles), and the quality of care.

Last week’s election results in the State of Louisiana reinforces the passion of the health care voter, voting with their feet and ballots in a state that expanded Medicaid. This will be seen as a bellwether for November 2020.