Patients vs. consumers: What’s in a name?

Oliver J. Kim1

1 Cross-Border Health, 5100 Columbia Pike, Arlington, VA, USA, 22204, okim@crossborderhealth.org

Following the passage of the Affordable Care Act, the American healthcare system is rapidly transforming in ways that are both exciting but potentially in conflict. On one hand, delivery systems are changing to meet new payer demands for more accountability, greater value, and a focus on managing a population’s health. At the same time, researchers are exploring targeting disease at an individual level using medicine that is “personalized.” In the middle are those receiving care and their caregivers. What is their role in this transformation, what kind of care do they want and need?

To involve the person receiving care, a dichotomy has emerged between two theories of care. On one side is a consumer voice for value and affordability and pushes providers toward improving population health and improving communities. On the other side is a patient voice for access to care and individualized care often associated with research and breakthrough technologies.

Affordability and access are not necessarily exclusive goals, but achieving both can be difficult because we may need to sacrifice one in order to achieve the other. Given this tension, can we bring both to the table and ensure that each voice is heard?

This paper will look at the roles of consumers and patients in the post-ACA era and how they are responding to changes in the healthcare system. First, the proposal will summarize a literature review on how the two terms are used. Second, the proposal will analyze how major advocacy organizations representing one or both of these interests describe themselves and how this affects their public advocacy agenda. Exploring these two concepts will help policy makers and health system leadership ensure that patients, consumers, and the perspective each represents are part of the process of designing the new, evolving healthcare system.


Biography

Oliver Kim is the executive director of Cross-Border Health, an organization which compares health policy among industrialized nations. In the United States Senate, he served as the senior health advisor to US Senator Debbie Stabenow and then as deputy director for the Special Committee on Aging under Chairman Bill Nelson. Additionally, Oliver was legislative director for Planned Parenthood Federation of America, overseeing congressional relations for the organization and its affiliates during one of the most critical times in the organization’s history. He was selected for the Woodrow Wilson foreign policy fellowship and the AcademyHealth Health Policy in Action award.