Healthcare: It’s Just Business

We like to say here at 4sight Health that healthcare is an industry no different from any other industry in terms of economic incentives, and that businesses in healthcare behave no differently than businesses in any other industry because of those economic incentives.

But what about consumers? Do healthcare consumers behave the same or differently than consumers in any other industry? According to a new research letter from the JAMA Health Forum, the answer is the same.

Eight health services researchers from the University of Pittsburgh Medical Center, the Cooper University Healthcare System in Camden, New Jersey, and the Charleston (West Virginia) Area Medical Center compared prostate cancer screening rates of men enrolled in high-deductible health plans (HDHPs) with the prostate cancer screening rates of men enrolled in traditional health plans (THPs).

The study pool was about 50,000 men aged 55 to 69 with health insurance and living in Western Pennsylvania. The study period was Jan. 1, 2017, through Dec. 31, 2023. The measured outcome was the percentage of men who got a prostate-specific antigen (PSA) test at least once during 24 months of consecutive enrollment in an HDHP or a THP during the study period.

The researchers calculated that the PSA screening rate for those in HDHP was 49%, or about 10% lower than the 54% PSA screening rate for those in THPs.

“These findings suggest that use of PSA screening is sensitive to deductible amount,” the researchers said.

Neither the result nor the researchers’ conclusions are surprising. If you’re asked to pay more for something you think you don’t really need, you’re not going to buy it. It’s typical consumer behavior. Healthcare is no different than any other industry in terms of economic incentives.

What is surprising is that we don’t take that knowledge — consumers in healthcare respond to financial incentives the same way consumers in any other industry do — and use it to shift the industry’s focus to health from healthcare. We don’t use that knowledge because incumbent healthcare businesses make more money from healthcare than they do health.

As they say in “The Godfather” movies, right before someone dies, “It’s not personal. It’s strictly business.”

No different from healthcare.

Thanks for reading.