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Sick Around The World
Consumer Behavior

• Consumers are beginning to use the same value
  criteria for healthcare decisions as they do with
  other purchasing decisions:
  •   Service
  •   Price
  •   Experience
  •   Brand equity…

• However we cannot see a widespread change in
  consumer behavior
Consumer Behavior

• With the adoption of consumer-driven plans and
  the current crisis, change is coming:
  • Many predict adoption of consumer-driven plans will
    rise to 15% in 2009, 50% in 2013 and 90% by 2016.
  • Crisis is causing more employers to drop health
    insurance altogether: 19% of employers are planning
    to stop offering health benefits over the next three to
    five years (five times higher than the previous year)
  • With a growing unemployment, the number of
    uninsured and underinsured increases
Consumer Behavior

• 53% of the households said they had cut back on
  healthcare in the previous year due to cost
  concerns (Kaiser Family Foundation Health
  Tracking Poll)

• Retailer CVS is closing 90 MinuteClinics for the
  reason to “align with consumer demand” (Wall
  Street Journal)

• “We are seeing that demand is far more elastic
  than it was in other years” (CEO of Park Nicollet
  Health Services in Minneapolis)
Consumer Behavior

• New consumer habits impact on healthcare providers:
  • The decrease in volume may be a permanent reduction of
    utilization stretch out physician visits and customer find
    lower-cost alternative (“home made”)
  • Price shopping will become the norm, as consumers
    carefully consider their alternatives and negotiate for lower
    costs
  • Convenience, experience and service will become the
    new value driver, relative to clinical quality, as patient
    demand more for their money
  • Competition in the healthcare market will become even
    more intense
Consumer Behavior
Financial Analysis
Healthcare cost
Healthcare cost
Job opportunities
Job opportunities
Some data from the USA…
            (2011)

• 16.5% of Americans are not covered by a
  healthcare plan

• 46% of all personal bankruptcies are related to
  healthcare costs

• US spends 15.9% of GDP or $6,657 per capita on
  healthcare (twice that of the next most expensive
  national expenditure ranking)
Some data from the USA…
             (2011)
• 20% of US healthcare
  dollars are lost to health
  insurance companies in
  the form of profits, and
  similar wastage numbers
  apply to big
  pharmaceutical companies

• American life expectancy
  at birth ranks 50th in the
  world

• American overall level of
  health ranks 72nd in the
  world
Britain preventive
                medicine
                               Negative (why it should
Positive (for the US):
                                not work in the US):
• System covers everybody       • Long waiting list for
• Never have to pay a             patients
  medical bill                  • Hospitals compete to
• Financed from the general       survive and not to make
  taxation                        profits
• No medical bankruptcy         • Too much government for
                                  the US
• Physicians are encouraged
  to keep people healthy        • Brits are much more taxed
  (bonus)
• World leader in preventive
  medicine
Britain Healthcare statistics vs
              USA
• Expenditure on health %
  GDP: 8.4%/ 16%

• Expenditure on health per
  capita: $2,992/ $7,290

• Expenditure from private
  sector: 12.9%/ 52.8%

• Infant mortality per 1,000
  births: 4.8/ 6.7

• Life expectancy at birth:
  79.1 years/ 78.1 years
Japan: No Gatekeepers
                                                    Negative (why it should
Positive (for the US):
                                                     not work in the US):
•   Spend half as much as the US on
    healthcare per capita                            • Doctors can’t get rich:
•   Longest life expectancy all over the world         undervalued and underpaid
•   Everybody has to sign up for a health
    insurance policy at work or through
    community (for jobless)
                                                     • Too much control by the
•   Japan’s system is largely private (80% of          government for prices
    hospitals)
                                                       regulation (“Big Brother”)
•   All citizens are covered and it is very cheap
    (fairness)                                       • Insurance companies are
•   Price regulation by the government to keep
    prices low                                         not allowed to make profits
•   Same prices everywhere in the country
                                                     • 50% of hospital are in
•   High tech system of healthcare
•   Patients can see any specialists they want         financial deficits
•   Competition between doctors, clinics and
    hospitals is fierce
                                                     • Japanese system spend
                                                       too little
Japanese healthcare statistics
              vs USA

• Expenditure on health %
  GDP: 7.1% / 16%

•    Expenditure on health per
    capita: $2,373/ $7,290

•    Life expectancy: 82.25
    years/ 78.1 years

• Infant mortality per 1,000
  births: 5/ 6.7
Germany: a market-based
            system
                                       Negative (why it should
Positive (for the US):
                                        not work in the US):
• 90 % of the population           •    Rich pay for the poor and the
  covered by the system
                                        ill are covered by the healthy
• German pay premium based
  on their income
• Population is highly satisfied
• Sickness funds (1,100)
  compete among themselves
  but are not allowed to make
  profits
• Sickness funds negotiate
  with drug companies and
  medical providers to keep
  prices low
• Excellent quality and
  efficiency of the system
German healthcare statistics vs
            USA

• Expenditure on health %
  GDP: 10.4% / 16%

• Expenditure on health per
  capita: $3,588/ $7,290

• Life expectancy: 80.07
  years/ 78.1 years

• Infant mortality per 1,000
  births: 3.54/ 6.7
Taiwan: a new system
                                     Negative (why it should
Positive (for the US):
                                      not work in the US):
• A mix of all the best ideas    •    Government spend too little
  for healthcare of all around        and is borrowing from banks
  the world                           to pay the providers (solution:
• Equal access to healthcare          increase the part of
                                      healthcare in the GDP)
• Free choice of doctors
• No waiting time
• Encourage lots of
  competition among medical
  providers
• Smart card
Taiwanese healthcare statistics
          vs USA

• Expenditure on health %
  GDP: 5.8% / 16%

• Expenditure on health per
  capita: $752/ $7,290

• Life expectancy: 78.32
  years/ 78.1 years

• Infant mortality per 1,000
  births: 5.18/ 6.7
Switzerland: a familiar
                system
                              Negative (why it should
Positive (for the US):
                               not work in the US):
• It is possible to fix the    • How much people are
  healthcare system              willing to pay the premium?
• Low administrative costs     • Switzerland average cost
• Keep cheap universal           of the premium:$750/month
  coverage
Switzerland healthcare
           statistics vs USA

• Expenditure on health %
  GDP: 11.8% / 16%

• Expenditure on health per
  capita: $4,500/ $7,290

• Life expectancy: 81.07
  years/ 78.1 years

• Infant mortality per 1,000
  births: 4.08/ 6.7
Healthcare around the world
Profits are dangerous for our
            health
• ”We should not allow the medical-industrial
  complex to distort our health care system to its
  own entrepreneurial ends, medicine must serve
  patients first and stockholders second. We are in
  a market-oriented health care system spinning out
  of control’ with commercial forces influencing
  doctors’ judgments and manipulating a credulous
  public.’” Arnold Relman (editors of the New
  England Journal of medicine)
Sources

• 2010 Global Survey of healthcare consumers
  behaviors

• Sick around the world (movie)

• The economic crisis: tipping point for healthcare
  consumer behavior

• Yahoo finance

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Sick around the world

  • 2. Consumer Behavior • Consumers are beginning to use the same value criteria for healthcare decisions as they do with other purchasing decisions: • Service • Price • Experience • Brand equity… • However we cannot see a widespread change in consumer behavior
  • 3. Consumer Behavior • With the adoption of consumer-driven plans and the current crisis, change is coming: • Many predict adoption of consumer-driven plans will rise to 15% in 2009, 50% in 2013 and 90% by 2016. • Crisis is causing more employers to drop health insurance altogether: 19% of employers are planning to stop offering health benefits over the next three to five years (five times higher than the previous year) • With a growing unemployment, the number of uninsured and underinsured increases
  • 4. Consumer Behavior • 53% of the households said they had cut back on healthcare in the previous year due to cost concerns (Kaiser Family Foundation Health Tracking Poll) • Retailer CVS is closing 90 MinuteClinics for the reason to “align with consumer demand” (Wall Street Journal) • “We are seeing that demand is far more elastic than it was in other years” (CEO of Park Nicollet Health Services in Minneapolis)
  • 5. Consumer Behavior • New consumer habits impact on healthcare providers: • The decrease in volume may be a permanent reduction of utilization stretch out physician visits and customer find lower-cost alternative (“home made”) • Price shopping will become the norm, as consumers carefully consider their alternatives and negotiate for lower costs • Convenience, experience and service will become the new value driver, relative to clinical quality, as patient demand more for their money • Competition in the healthcare market will become even more intense
  • 12. Some data from the USA… (2011) • 16.5% of Americans are not covered by a healthcare plan • 46% of all personal bankruptcies are related to healthcare costs • US spends 15.9% of GDP or $6,657 per capita on healthcare (twice that of the next most expensive national expenditure ranking)
  • 13. Some data from the USA… (2011) • 20% of US healthcare dollars are lost to health insurance companies in the form of profits, and similar wastage numbers apply to big pharmaceutical companies • American life expectancy at birth ranks 50th in the world • American overall level of health ranks 72nd in the world
  • 14. Britain preventive medicine Negative (why it should Positive (for the US): not work in the US): • System covers everybody • Long waiting list for • Never have to pay a patients medical bill • Hospitals compete to • Financed from the general survive and not to make taxation profits • No medical bankruptcy • Too much government for the US • Physicians are encouraged to keep people healthy • Brits are much more taxed (bonus) • World leader in preventive medicine
  • 15. Britain Healthcare statistics vs USA • Expenditure on health % GDP: 8.4%/ 16% • Expenditure on health per capita: $2,992/ $7,290 • Expenditure from private sector: 12.9%/ 52.8% • Infant mortality per 1,000 births: 4.8/ 6.7 • Life expectancy at birth: 79.1 years/ 78.1 years
  • 16. Japan: No Gatekeepers Negative (why it should Positive (for the US): not work in the US): • Spend half as much as the US on healthcare per capita • Doctors can’t get rich: • Longest life expectancy all over the world undervalued and underpaid • Everybody has to sign up for a health insurance policy at work or through community (for jobless) • Too much control by the • Japan’s system is largely private (80% of government for prices hospitals) regulation (“Big Brother”) • All citizens are covered and it is very cheap (fairness) • Insurance companies are • Price regulation by the government to keep prices low not allowed to make profits • Same prices everywhere in the country • 50% of hospital are in • High tech system of healthcare • Patients can see any specialists they want financial deficits • Competition between doctors, clinics and hospitals is fierce • Japanese system spend too little
  • 17. Japanese healthcare statistics vs USA • Expenditure on health % GDP: 7.1% / 16% • Expenditure on health per capita: $2,373/ $7,290 • Life expectancy: 82.25 years/ 78.1 years • Infant mortality per 1,000 births: 5/ 6.7
  • 18. Germany: a market-based system Negative (why it should Positive (for the US): not work in the US): • 90 % of the population • Rich pay for the poor and the covered by the system ill are covered by the healthy • German pay premium based on their income • Population is highly satisfied • Sickness funds (1,100) compete among themselves but are not allowed to make profits • Sickness funds negotiate with drug companies and medical providers to keep prices low • Excellent quality and efficiency of the system
  • 19. German healthcare statistics vs USA • Expenditure on health % GDP: 10.4% / 16% • Expenditure on health per capita: $3,588/ $7,290 • Life expectancy: 80.07 years/ 78.1 years • Infant mortality per 1,000 births: 3.54/ 6.7
  • 20. Taiwan: a new system Negative (why it should Positive (for the US): not work in the US): • A mix of all the best ideas • Government spend too little for healthcare of all around and is borrowing from banks the world to pay the providers (solution: • Equal access to healthcare increase the part of healthcare in the GDP) • Free choice of doctors • No waiting time • Encourage lots of competition among medical providers • Smart card
  • 21. Taiwanese healthcare statistics vs USA • Expenditure on health % GDP: 5.8% / 16% • Expenditure on health per capita: $752/ $7,290 • Life expectancy: 78.32 years/ 78.1 years • Infant mortality per 1,000 births: 5.18/ 6.7
  • 22. Switzerland: a familiar system Negative (why it should Positive (for the US): not work in the US): • It is possible to fix the • How much people are healthcare system willing to pay the premium? • Low administrative costs • Switzerland average cost • Keep cheap universal of the premium:$750/month coverage
  • 23. Switzerland healthcare statistics vs USA • Expenditure on health % GDP: 11.8% / 16% • Expenditure on health per capita: $4,500/ $7,290 • Life expectancy: 81.07 years/ 78.1 years • Infant mortality per 1,000 births: 4.08/ 6.7
  • 25. Profits are dangerous for our health • ”We should not allow the medical-industrial complex to distort our health care system to its own entrepreneurial ends, medicine must serve patients first and stockholders second. We are in a market-oriented health care system spinning out of control’ with commercial forces influencing doctors’ judgments and manipulating a credulous public.’” Arnold Relman (editors of the New England Journal of medicine)
  • 26. Sources • 2010 Global Survey of healthcare consumers behaviors • Sick around the world (movie) • The economic crisis: tipping point for healthcare consumer behavior • Yahoo finance