If anyone is happy with the status of the healthcare system in the U. S. today, that person is keeping awfully quiet.
From anti-managed care legislation in Congress, to providers who are being told by HCFA to tighten their belts even more, it seems that nearly every segment of the industry is angry and frustrated. And reporters and editors, on the other hand, have daily healthcare horror stories to cover.
Stuck in the middle of the provider-payer-insurer battles are consumers, frightened by negative headlines, confused about whether they should like or hate their new health plan. Consumers are anxious about the future of healthcare, united in their irritation that they have to make the changes and bear the fallout from fixing something they didn't think was broken in the first place.
And as they watch the key players - doctors, insurers, hospitals and others - fighting for their share of an ever-shrinking pie, and blaming someone else for the crisis, consumers are growing increasingly skeptical and cynical.
Focus groups with consumers reveal that they do not perceive any group as "winning" the current battles and, in fact, they wonder if anyone is really acting on behalf of the patients.
This is significant because at the heart of the healthcare relationship between patient and healthcare providers is trust.
How Did We Get Here?
The state of healthcare is in crisis and there are a number of communications issues to manage, including:
- Misaligned incentives: Business leaders and their workers have never been on the same page in terms of accepting the need for changes that would help slow cost escalation. Rarely was the news translated effectively into terms that were relevant to consumers who were being asked to change the way they received healthcare or was there a solid understanding of the "why" behind the "what."
- The "quick-fix, magic bullet" mentality: The healthcare "system," an industry made up of interrelated but often conflicting sectors, is incredibly complex, and absolutely cannot be fixed overnight. That story never has been widely told, because it doesn't lend itself to sound bites, and because there's no simple, easy solution.
The obsession with finding a magic pill created runaway expectations for marketplace reform, heightened by media coverage that, as always, focused on heroes and villains.
The concept of managed care was originally described in glowing terms by the press. But when it was implemented and fairly predictable glitches and problems arose, the pendulum swung and HMOs became villains. Hospitals, once thought of as "white hats," became feared as bottom-line driven, uncaring organizations when they tried to become more efficient. The system is being characterized in black or white, good or bad terms -there is no grey.
- Rhetoric and ridicule instead of industry-led education and consensus-building: The blame game has become the order of the day - doctors attacking insurers, HMOs criticizing providers, every sector pointing the finger.
In an industry under siege, there areno easily recognizable, credible spokespeople who are regularly on the lecture circuit and airwaves with facts rather than propaganda. Consumers are seeing a parade of leaders from each sector defending their own self-interests.
Health System, Heal Thyself
PR professionals must take the lead in helping all sectors of the industry develop basic, common sense initiatives:
- Just Do It. Instead of saying "We're the good guys," be the good guys. Healthcare organizations need to stop sending messages and start listening - to patients, consumers, community leaders- and develop programs that will truly benefit the community, not just "increase market share."
- Call a cease fire. End the blame game. Replace competition with cooperation by developing partnerships. Nationally, it has to happen within industry sectors and across the industry. Every sector of the industry has a stake and a role in improving public health. If doctors, HMOs, hospitals and pharmaceutical companies and all the other players, worked together in partnerships, the direct benefit would be a healthier country.
- Replace rhetoric with education and dialogue. Instead of diatribes about who's to blame, or branding campaigns that focus on sell, sell, sell, all parties need to collectively begin a dialogue based upon careful exploration of the facts and the issues. This dialogue could lead to programs that help consumers have a better understanding of the issues.
Each of these efforts can best be initiated at the local level where most consumers receive their healthcare.
If patients are to understand their health conditions and needs, to heed and act on recommendations on how to stay healthy or prescriptions to help them get well, they must trust their providers and health care organizations.
- Kathy Lewton, Porter Novelli
Kathy Lewton is director of the National Health Care Practice at Porter Novelli in Chicago. She is author of Public Relations in Health Care: A Guide For Professionals. She can be reached at 312/856-8888; email: [email protected]