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Since 2008, the Deloitte Center for Health Solutions has conducted its annual survey of health care consumers to assess behaviors, attitudes and unmet needs, and to quantify year-to-year changes. The significant role that consumers play in health care is often under-reported or discounted. Consumers include those with insurance and those without, those with medical problems under the care of traditional providers and those who seek alternative methods. It includes those who take prescription drugs, and many who choose over-the-counter therapies desiring a similar result. Consumerism in health care is a complex theme; it embraces how people care for themselves and others, how they use their time and money and how they choose providers, insurance plans and treatment options consistent with their needs and values. In tandem with this year's survey of health care consumers in the United States, we surveyed consumers in France, Switzerland, Germany, Canada and the United Kingdom. The differences are striking: For example, consumer expectations about the US health care system are high. Of the six countries surveyed, US consumers grade our system above Germany's but below all the others. Are consumer expectations of the US system reasonable? Can unmet needs be met cost-effectively? Can consumers navigate the system by making choices that are reasoned and fact-based? Our findings suggest that we have a long way to go. Consumers are a powerful force in health care. To discount their role, to understate their impact and to relegate them to passive participants is a mistake. Reinforcing old paradigms that assume consumers will "Go along" with the status quo is short-sighted.
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