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2010 Global Surveyo Health Care ConsumersBehaviors, attitudes and unmet needs
Produced by the Deloitte Center or Health Solutions
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Contents
Foreword 3
The conceptual ramework: Six zones o health care consumerism 4
Survey highlights 7
Zone One: Wellness and healthy living 9
Zone Two: Inormation resources 12
Zone Three: Traditional health services 14
Zone Four: Alternative health services 16
Zone Five: Health insurance 17
Zone Six: Health policy 19
Major fndings 20
Implications 22
Contacts 23
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In most o the worlds developed systems o health care, costs are increasing at alarming
rates as the compound eects o aging, chronic disease prevalence and unhealthy
liestyles escalate demand or resources. And in every system citizens expect modern
acilities and technologies, readily accessible physicians and assurance that their healthcare needs will be met.
Most health care systems view citizens as patients individuals with occasional need
or primary or acute care, directed by physicians to ollow prescribed treatment plans, and
immune to consequences or non-adherence.
A system orientation toward citizens as consumers rather than patients is a undamental
shit: it presumes that consumers and their providers, when equipped with appropriate
tools coupled with incentives to reward improved outcomes, have the potential to lower
costs and improve satisaction.
The results o this Deloitte2010 Global Survey of Health Care Consumers suggest that
opportunities exist or leaders in developed systems to accelerate their eorts towardconsumerism. The majority o consumers in each o the six surveyed countries Canada,
the United States, Germany, France, Switzerland and the United Kingdom are somewhat
satised with their systems perormance, but disconnected rom its costs and seemingly
passive about the role they play.
Engaging consumers in health care is essential to systemic reorms that reduce costs and
improve population-based outcomes. Survey ndings suggest that each o the six systems
has opportunity to accelerate eorts toward consumerism.
Paul H. Keckley, Ph.D.Executive Director
Deloitte Center or Health Solutions
Deloitte LLP
Washington DC
Dean ArnoldHealth Care Sector Leader
Deloitte Touche Tohmatsu
London
Foreword
As used in this document, Deloitte means Deloitte LLP. Please see www.deloitte.com/us/about
or a detailed description o the legal structure o Deloitte LLP and its subsidiaries.
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The Deloitte2010 Global Survey of Health Care Consumers
series provides insights about the behaviors, attitudes and
unmet needs o consumers in France, Germany, Switzerland,
the United Kingdom, Canada and the United States.
The 2010 survey refects a broad-based view o health care
consumerism in six zones (Figure 1):
Wellness and healthy living: What individuals aredoing to care or themselves.
Inormation resources: What sources o
inormation are useul in inorming their decisions.
Traditional health services: How consumers assess
the perormance and value o physicians, hospitals,
medical devices and prescription drugs accessible in
their system o care.
Alternative health services: In addition to traditional
services, what other services consumers use to achieve
their health goals or manage their conditions.
Health insurance: How consumers manage the
costs and risks associated with the services they use
or oresee using. Health policy: How consumers assess the overall
perormance o the system.
Methodology
Deloitte surveyed health care consumers across Canada,
the United States, Germany, Switzerland, France and the
United Kingdom. To reduce response bias and enhance the
predictive value o the survey results to actual utilization
data, participants in each country were rst asked about
recent behaviors (past week/past month/past year), then
about attitudes, within each topic area. Results were
weighted to assure proportional representation to eachcountrys census population with respect to age, gender,
income and geography. A core set o common questions
were asked in each country, supplemented by questions
tailored to each unique health system.
Across the our European countries, the response margin
o error is +/- 3.1% at a .95 condence level. In Canada,
the response margin o error is +/- 2% at a .95 condence
level. In the United States, the response margin o error is
+/- 1.6% at the .95 condence level.
France: A national sample o 1,000 French adults,
aged 18 and older, was surveyed in July 2009, using a
web-based questionnaire that consisted o 88 questions,
with 49 potential ollow-up questions.
Germany: A national sample o 1,000 German adults,
aged 18 and older, was surveyed in July 2009, using a
web-based questionnaire that consisted o 90 questions,
with 46 potential ollow-up questions.
Switzerland: A national sample o 1,000 Swiss adults,
aged 18 and older, was surveyed in July 2009, using a
web-based questionnaire that consisted o 97 questions,
with 42 potential ollow-up questions.
The conceptual ramework:Six zones o health care
consumerism
2010 Deloitte Development LLC. All rights reserved.
Figure 1: Zones of health care consumer activity
Health care
consumerism
1. Wellness
and healthy
living
2. Informationresources
3. Traditionalhealth
services
4. Alternativehealth
services
5. Healthinsurance
6. Healthpolicy
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United Kingdom: A national sample o 1,000 British
adults, aged 18 and older, was surveyed in July 2009, using
a web-based questionnaire that consisted o 96 questions,
with 49 potential ollow-up questions.
Canada: A national sample o 2,304 Canadian adults,
aged 18 and older, was surveyed in November 2008, using
a web-based questionnaire that consisted o 74 questions,
with 46 potential ollow-up questions.
United States: A nationally representative sample o 4,001
American adults, aged 18 and older, was surveyed in October
2008, using a web-based questionnaire that consisted o
95 questions, with 42 potential ollow-up questions.
Background: Health care systems across Europe,
Canada and the United States
The six countries vary in the structures o their health
care delivery systems, the role played by private insurance
and provider organizations, and governance. Health care
expenditures as a percentage o each countrys grossdomestic product (GDP) range rom 8.4% in the United
Kingdom to 16.2% in the United States (Figure 2).
France has a statutory national health insurance system
with compulsory coverage o French residents through
health insurance unds whose participants are determined
primarily according to their occupation. The system is
nanced mainly through social security contributions by
employers and employees, taxes on alcohol and tobacco,
and out-o-pocket payments. In 2006, 99.9% o the
French population had public coverage. Also, 88.4%, or
54 million, had voluntary private health insurance. Thirtychronic conditions, including diabetes, are ully covered.
Physicians are organized into unions and the government
pays on a ee-or-service basis, based on negotiated rates.
Hospital rates are set by the government.
Germany has a statutory national health insurance system
with compulsory coverage o all German residents through
health insurance unds whose participants are determined
primarily based on their occupation. Up to a certain income
level, all employees are required to join one o about 250
statutory health insurance unds. Persons earning a higher
gross income are allowed to join a private plan. In 2006,
89.5% o the German population had public coverage.Also, 26.1% o the German population in 2006 had private
health insurance, primary and supplemental coverage.
Figure 2: Country comparisons: Health care expenditures
Country
Health Care
Expenditures as
Percent o GDP
Per-capita
Spending
$USD
Public Expenditure
on Health,
Percent o Total
Canada 10.1% $3,895 70.0%
France 11.0% $3,601 79.0%
Germany 10.4% $3,588 76.9%
Switzerland 10.8% $4,417 59.3%
United Kingdom 8.4% $2,992 81.7%
United States 16.0% $7,290 45.4%
Source: OECD Health Data 2009, based on 2007 data
2010 Deloitte Development LLC. All rights reserved.
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Switzerland has a statutory national health insurance
system with compulsory coverage o all Swiss residents
through plans purchased by individuals rom a selection
o approximately 90 competing private health insurance
unds. All residents and dependents are required to have
coverage unless they have insurance in another EU member
country. Approximately 99% o the 7.6 million Swiss
residents are covered by compulsory insurance. The Swiss
system is unded by premium payments, out-o-pocketpayments by individuals and government unding.
United Kingdom has a national health system wherein
coverage is universal and managed by the government.
Hospitals are owned by the government and physicians
are paid a salary by the government and ees rom private
insurance. Financing comes rom employment taxes
and social security. Also, 10% o the UK population has
private insurance.
Canada has a national health system, governed and
delivered by each provincial jurisdiction, wherein coverage
is universal, portable across provinces and publicly insured
or medically necessary services. Hospitals and regional
health systems are not-or-prot corporations unded
primarily by provincial governments, and physicians
are paid through a mix o ee-or-service and salary
compensation. Financing or publicly unded services
comes rom provincial and ederal taxes. The majorityo Canadians also have supplemental private health
insurance, and private health spending on insurance and
out-o-pocket expenses amounts to 30% o total annual
health spending across the country.
United States has health care that is unded by private
insurance, individuals and the government. There are
multiple payers and no individual or employer mandate.
Approximately 46 million (16%) o the US population
is uninsured. Almost all people over the age o 65 have
insurance coverage, and approximately 80% o the
under-65 population has coverage.
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Perspectives on the overall perormance o
countries health care systems
The majority o consumers do not understand
the health care system in their country.
37% o French and Canadian adults believe that
they have a complete understanding o their
health care system.
This compares with 28% o American, 27% o
British, 23% o Swiss and 22% o German adults
who report having a complete understanding o
their health care system; in each o these countries
the percent o respondents who report having
limited or no understanding o their health care
system is also higher (Figure 3).
The French and Swiss grade their systems
perormance higher than others; Germans and
Americans rate their system lowest.
55% o French and Swiss adults give their health care
system a grade o A or B, while 44% o German
adults and 35% o American adults give their systema ailing grade o D/F (Figure 4).
Males in all countries grade their health care system
higher than emales.
59% o French and Swiss males give their health
care system an A/B compared with 51% o French
emales and 49% o Swiss emales.
23% o German males and 11% o German emales
give their system an A/B grade.
Survey highlights
Understanding of health care system
2010 Deloitte Development LLC. All rights reserved.
Complete ly (8, 9 or 10) Not at all (1 , 2 or 3)
0%
37%
6%
37%
7%
28%15%
27%
10%
23%
12%
22%
16%
5% 10% 15% 20% 25% 30% 35% 40%
Canada
France
US
UK
Switzerland
Germany
Figure 3: How well do you think you understand how your health care system works?
Figure 4: Using a typical report card scale with grades A, B, C, D, and F, how would
you grade the overall performance of your health care system?
Health care system grade
2010 Deloitte Development LLC. All rights reserved.
Excellent-A/B Failing-D/F
55%
12%
55%
14%
43%
15%
30%
20%
21%
35%
17%
44%
France
Switzerland
Canada
UK
US
Germany
0% 10% 20% 30% 40% 50% 60%
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Wasteulness in the health care system o each
country is a concern: the US respondents are more
critical than citizens in other countries (Figure 5).
Perceived wasteulness is lowest in Switzerland, which is
graded highest in overall perormance compared to the
other countries; however, this correlation is not consistent
across countries: Although France is also graded highest
or overall perormance, citizens perceive the system as
having the second-highest level o wasted spending.
Figure 5: In your opinion, what percentage of all health care dollars spent is wasted?
Believe >50% percent of health care system spending is wasted
2010 Deloitte Development LLC. All rights reserved.
28%
17%
15%
14%
12%
10%
US
France
UK
Canada
Germany
Switzerland
0% 5% 10% 15% 20% 25% 30%
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Sel-reported health status is highest in Canada
and the US; Germans and French report the lowest
health status.
61% o Canadian and 60% o American adults rate
their overall health as excellent or very good, while
23% o German adults rate their health as excellent
or very good (Figure 6).
A similar trend is observed across age cohorts; or
example: 15% o Germans age 45-64 considerthemselves to be in excellent or very good health,
while 56% o Canadians and 55% o US adults in
the same age group consider themselves to be in
excellent or very good health.
A greater percentage o European males rate
their health status as excellent or very good
compared with European emales.
1 in 3 Germans and 1 in 4 French rates their health
status as air/poor.
A majority o consumers in Germany, France and
the United States report having one or more
chronic conditions.
57% o adults in Germany, and 52% o adults in both
France and the US report being diagnosed with one or
more chronic conditions (Figure 7).
More than 64% o adults age 65+ report
having one or more chronic conditions; in the
United States, 81% o adults age 65+ report
having one or more chronic conditions.
In all countries except Switzerland, a majority
(>56%) o adults age 45-64 report having one
or more chronic conditions.
In all countries surveyed, a trend exists across health
status and chronic disease: Over 80% o consumerswith one or more chronic diseases report air or
poor health status.
Zone One:Wellness and healthy living
Figure 6: How would you rate your overall health?
2010 Deloitte Development LLC. All rights reserved.
Excellent/very good Failing/poor
Physical health status
61%
8%
60%
9%
51%12%
49%
16%
31%
25%
23%
37%
Canada
US
Switzerland
UK
France
Germany
0% 10% 20% 30% 40% 50% 60% 70%
Figure 7: Have you been diagnosed by a doctor or other medical professional as
having one or more chronic conditions?
Percent diagnosed with one or more chronic diseases
2010 Deloitte Development LLC. All rights reserved.
0% 10% 20% 30% 40% 50% 60%
57%
52%
52%
47%
47%
39%
Germany
France
US
UK
Canada
Switzerland
% with chronic disease
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In general, consumers are not engaged in health
and wellness programs: ewer than 1 in 5 say they
participated in a healthy living program in the
prior year.
US consumers report higher levels o participation
than others; French, Swiss and British participation
is the lowest (Figure 8).
Across all countries surveyed, presence o
a chronic disease or sel-reported lowerhealth status does not appear to drive higher
participation in wellness programs.
Interest in participating in wellness programs is
relatively modest: about hal o survey respondents
in each country say they would be highly likely
to participate.
Trends are observed between current participation in a
wellness program and interest in participating in such
programs going orward: 59% o American adults
(highest) compared to 44% o French adults (lowest)
report that they would be highly likely to participate in awellness program i it was oered at no cost (Figure 9).
Across all countries, emales are more likely than males
to be highly interested in participating in a wellness
program i it was oered at no cost.
Figure 8: Have you participated in a healthy living/wellness program in the last 12 months?
Participation in healthy living/wellness program
2010 Deloitte Development LLC. All rights reserved.
US
Canada
Germany
Switzerland
UK
France
0% 5% 10% 15% 20%
6%
10%
10%
14%
16%
20%
Figure 9: If you were given the opportunity to participate in a wellness program for
free, how likely is it that you would do so?
Likelihood of participation in wellness program
2010 Deloitte Development LLC. All rights reserved.
Highly l ikely (8, 9 or 10) Not at al l l ikely (1, 2 or 3)
Canada
US
Switzerland
UK
France
Germany
0% 10%
21%
44%
16%
47%
12%
55%
11%
57%
59%
9%
16%
56%
20% 30% 40% 50% 60%
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Among consumers with one or more chronic
conditions, participation in disease management
programs is highest in Germany and France; it is
lowest in the UK and US.
For consumers with one or more chronic diseases,
approximately 7 o 10 in all countries adhere to their
recommended treatment regimen (Figure 10).
In all countries surveyed, except or the US,
participation by individuals with one or more chronicdiseases in a specic disease management program
appears to be higher than participation in broader
health and wellness programs.
Among most consumers, interest in remote
monitoring tools to support improved health
and wellness is strong.
Consumers in all countries identiy a high level o interest
in remote or home monitoring devices as tools to help
them sel-manage their health; interest is higher in the
UK, US, and Canada compared with Germany, France and
Switzerland (Figure 11). Interest in personal health coaching was expressed
by 32% o Americans (highest) and 19% o French
consumers (lowest).
Across all countries surveyed, interest in care
coordinators to help navigate the health care system,
or less personalized aids such as participation in
support groups with people who have similar health
conditions, was lower.
Figure 10: Do you currently participate in a disease management program and do
you follow the treatment regimen for your chronic condition?
Compliance with treatment regimen and participation in disease management program
Compliance with treatment
regimen for chronic disease
Participation in disease
management program
0%
10%
20%
30%
40%
50%
60%
70%
80%70%
78%74%
69% 72%
33%32% 28% 24%
14% 13%
70%
2010 Deloitte Development LLC. All rights reserved.
Canada
United States
United Kingdom
Germany
France
Switzerland
Figure 11: If you needed care or treatment, and these special services were availableto you, how interested would you be in using them?
2010 Deloitte Development LLC. All rights reserved.
Remote monitoring devices
Personal health coach
In-home medical device
Care coordinator
Interest in tools and aids to support self-managed care
0% 10% 20% 30% 40% 50% 60% 70% 80%
68%64%
26%22%
67%63%
32%29%
66%64%
29%24%
56%45%
20%13%
55%49%
26%22%
53%49%
19%20%
UK
US
Canada
Switzerland
Germany
France
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Most consumers do not compare hospitals or
physicians beore making a selection; US and
German consumers are consistently more likely
to shop compared to others (Figure 12).
In seeking inormation about the eectiveness
and saety o treatment options, consumers in all
countries consider academic medical centers and
physicians as their most trusted sources. Consumers in all countries identiy academic medical
centers and medical societies/associations (physicians)
as their most trusted sources o inormation on the
eectiveness and saety o treatments (Figure 13).
Other sources o inormation such as government,
health insurers, pharmacies, lie sciences companies,
independent health websites and other hospitals are
consistently rated lower across the countries surveyed.
Zone Two:Inormation resources
Figure 12: Have you compared physicians or hospitals before choosing one?
2010 Deloitte Development LLC. All rights reserved.
United States
Germany
Canada
Switzerland
United Kingdom
France
Percent who compare physicians and hospitals before making a selection
Percent who compare hospitals
before making a selection
Percent who compare physicians
before making a selection
15%
13% 13%
9% 9%8%
30%
24%
13%
16%15% 15%
0%
5%
10%
15%
20%
25%
30%
Figure 13: If you wanted information about the most effective and safe treatment(s)
for a certain health condition, how much trust do you have for these third party
sources to provide reliable information?
Trusted sources for information on treatment effectiveness and safety
2010 Deloitte Development LLC. All rights reserved.
Canada
United States
France
United Kingdom
Switzerland
Germany
Academic medical centers Medical societies/associations
0%
10%
20%
30%
40%
50%
60%53% 52% 51%
47%43%
37%
53%50%
27%
54%
46%
23%
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Consumers want access to online tools and services
that help them to understand their health care
inormation, navigate the health care system and
connect to their health care providers.
O several tools considered, consumers in all countries
consistently report the highest level o interest in access
to a secure Internet site that allows them to schedule
oce visits, access medical records, view test results,
order prescription rells, nd inormation about treatmentoptions, and check status o bills/payments (Figure 14);
access to their doctor via email is the second-highest
rated online tool by consumers.
On average, 35% are highly interested in using an
online personal health record (PHR) connected to their
doctors oce, to help them manage their health and
interactions with the health care system (Figure 14);
Americans and Canadians are most interested (>40%),
and Germans and Swiss are least interested (
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Consumers, especially in the US, Canada and
UK, preer primary care physicians who are
prescriptive in their approaches.
38% o Swiss consumers report preerring a physician
who acts as a health coach (highest), who provides
guidance and inormation needed or consumers to
make their own decisions, compared with 20% o US
consumers who preer a health coaching model (lowest).
British consumers state the highest preerence orphysicians who act as a medical authority (44%), who
directs them to take what he/she believes is the best
approach based on their own expertise, compared to
22% o Swiss and French consumers (lowest).
Prescription medications
Prescription drug utilization varies widely: it
is highest in France and the US, and lowest in
Switzerland (Figure 19).
The variation in prescription medication use is aligned
to the variation o consumer-reported chronic disease
prevalence across countries: Switzerland has thelowest reported incidence o chronic disease and
prescription drug use; France is among the highest.
Although over 80% o consumers in all countries
report adhering to drug labels and to instructions
provided by their doctors, less than 40% in each
country report "always" taking their medication
as directed.
Figure 18: Do you generally prefer a doctor who acts as a health coach or a doctor
who acts as a medical authority?
2010 Deloitte Development LLC. All rights reserved.
I prefer a doctor who acts as a medical authority
I prefer a doctor who acts as a health coach
Preference of physician style
0% 10% 20% 30% 40% 50%
UK
US
Canada
Germany
France
Switzerland
44%
20%
36%
20%
33%
25%
27%
33%
22%
34%
22%
38%
2010 Deloitte Development LLC. All rights reserved.
% who use prescription drugs
Figure 19: Percent of consumers who use prescription medication
Prescription drug usage
63%
57%
53%
47%
47%
33%
France
US
Germany
UK
Canada
Switzerland
0% 10% 20% 30% 40% 50% 60% 70% 80%
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Use o alternative health services varies and is
generally low; consumers are not inclined to
substitute/augment traditional therapies with
alternative methods o care.
Canadian (25%) and Swiss (22%) consumers are
the highest users o alternative health services
(e.g., acupuncture, naturopathy, chiropractic),
while French consumers are the lowest (Figure 20).
A large majority o consumers in all countries donot substitute a traditional health therapy (e.g.,
prescription medications) or alternative therapies.
Consumers typically preer physicians with a
traditional vs. holistic medicine orientation;
interest in physicians who integrate non-traditional
methods o care into practice is strongest in the US,
UK and Canada.
33% o American and 32% o British adults preer
a medical proessional with an orientation toward
traditional medicine, while 21% o German and
Swiss adults preer a medical proessional withan orientation toward holistic or alternative
treatments (Figure 21).
Across all six countries, a greater percentage
o males preer a traditional approach versus
a holistic orientation.
Across all six countries, adults age 65+ preer
a proessional with an orientation toward
traditional medicine.
Figure 20: Have you treated a health problem with an alternative or natural therapy?
Treatment of health problem with alternative or natural therapy
0% 5% 10% 15% 20% 25%
2010 Deloitte Development LLC. All rights reserved.
% who treated health problem with alternative therapy
25%
22%
19%
16%
15%
13%
Canada
Switzerland
US
UK
Germany
France
0% 5% 10% 15% 20% 25% 30% 35%
Figure 21: Do you prefer a doctor or medical professional with an orientation toward
holistic or alternative treatment or one with an orientation toward traditional medicine?
Preference for physicians with a holistic vs. traditional medicine practice orientation
2010 Deloitte Development LLC. All rights reserved.
Traditional medicine Holistic or alternative treatment
US
UK
Canada
France
Switzerland
Germany
33%
10%
32%
7%
27%
15%
26%
9%
19%
21%
13%
21%
Zone Four:Alternative health services
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Regardless o the systems fnancing or insurance
structure, the majority o consumers believe they
are not adequately insured.
Coverage by public vs. private supplemental
insurance varies across countries due to the nature
o the health care system in each country; 86% o
French consumers have supplemental insurance,
compared with 17% o Swiss consumers.
Although 2 o 3 consumers in most countries reportbeing adequately insured, less than 30% report
being well-insured; US consumers report higher
levels, with 39% identiying themselves as being
well insured (Figure 22).
Reported household spending or health care in the
prior year increased in every country: consumers
in Switzerland and the US report higher spending
sensitivity; less in the UK and Canada.
The majority o consumers in all six countries report
that health care spending has either increased or
stayed the same in the past 12 months (Figure 23). 59% o Swiss adults, 47% o American adults, and
46% o French adults report that their health care
spending has increased over the last 12 months;
less than 7% in each country report that health
spending has decreased.
Figure 22: Thinking about the amount and types of health insurance coverage you
have, both public and private, do you consider yourself to be adequately insured?
Adequacy of insurance
2010 Deloitte Development LLC. All rights reserved.
% well-insured
0% 5% 10% 15% 20% 25% 30% 35% 40%
39%
29%
25%
25%
22%
20%
US
Switzerland
France
Canada
Germany
UK
Figure 23: In the last 12 months, has your household spending on health care
products and services increased, decreased or stayed about the same compared
to the previous year?
0%
59%32%
5%
47%42%
7%
46%41%
5%
44%48%
3%32%
59%5%
23%65%
5%
10% 20% 30% 40% 50% 60% 70% 80%
Switzerland
US
France
Germany
Canada
UK
2010 Deloitte Development LLC. All rights reserved.
Increased Stayed the same Decreased
Zone Five:Health insurance
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Consumers see areas or improvement in their
system: increased access to primary care services
rom physicians and nurses, increased unding
to accelerate use o electronic medical records,
perormance-based payments or providers are
the highest priorities.
Increasing the availability o primary care physicians is
supported by a majority o consumers in all countries;
consumer support is highest in Canada, the US andUK (Figure 25).
Expanding unding to improve adoption o electronic
health care records is also one o the top-supported
health care system reorm priorities; support is highest
in Canada and lowest in Germany.
An average o 40% o consumers in all countries
support establishing pay-or-perormance systems
or doctors and hospitals; however, more than 1 in 5
consumers oppose this reorm in each country, and in
Germany 46% o consumers are opposed.
Figure 25: Top Health Policy Reorms
Health Reorm Canada France Germany Switzerland UK US
Expand teaching programs to
increase the supply o primary
care physicians
85% 56% 52% 55% 72% 74%
Allow nurses to diagnose
and treat uncomplicated
conditions
59% 45% 42% 39% 57% 47%
Increase government unding
to support adoption o
electronic health records
58% 49% 34% 41% 48% 40%
Establish perormance-basedsystems that pay doctors and
hospitals based on clinical
outcomes vs. service volumes
37% 41% 40% 39% 39% 40%
2010 Deloitte Development LLC. All rights reserved.
Zone Six:Health policy
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Figure 26: Health care survey results, by country
Domains o health care consumer activity Canada France Germany SwitzerlandUnited
KingdomUnitedStates
Overallhealth system
Percent who give the health care system a grade o A or B 43% 55% 17% 55% 30% 21%
Percent who eel they have a good understanding o how thehealth care system works
37% 37% 22% 23% 27% 28%
Percent who believe that more than 50% o health care systemspending is wasted
14% 17% 12% 10% 15% 28%
Wellness andhealthy living
Percent who rate their physical health care as excellent or very good 61% 31% 23% 51% 49% 60%
Percent participating in wellness programs 16% 6% 14% 10% 10% 20%
Percent willing to participate in a wellness program at no cost 56% 44% 57% 47% 55% 59%
Percent reporting one or more chronic diseases 47% 52% 57% 39% 47% 52%
Percent who participate in a disease management program 33% 14% 24% 13% 28% 32%
Percent interested in remote and/or home monitoring devices 64% 49% 49% 45% 64% 63%
Inormationresources
Percent who compare hospitals beore making a selection 13% 8% 13% 9% 9% 15%
Percent who compare doctors beore making a selection 13% 15% 24% 16% 15% 30%
Percent who maintain a Personal Health Record 6% 7% 6% 6% 4% 9%
Percent highly concerned about privacy or health inormationstored online
34% 44% 52% 53% 36% 38%
Traditionalhealthservices
Percent who have stayed overnight in a hospital or surgical,non-surgical or emergency treatment
15% 28% 24% 25% 16% 17%
Percent satised with recent hospital care 62% 64% 59% 65% 63% 73%
Percent who have a doctor who unctions as primary care provider 84% 94% 88% 76% 70% 80%
Percent satised with their primary care physician 74% 71% 73% 74% 65% 71%
Percent who use prescription medication 47% 63% 53% 33% 47% 57%
Alternativehealthservices
Percent who treated a health problem with alternativeor natural therapies
25% 13% 15% 22% 16% 19%
Preer doctor with orientation toward holistic or alternative treatments 13% 11% 26% 24% 9% 12%
Healthinsurance
Percent who eel nancially well-prepared or uture health care costs 39% 31% 25% 29% 29% 27%
Percent who consider themselves to be well-insured 25% 25% 22% 29% 20% 39%
2010 Deloitte Development LLC. All rights reserved.
8/6/2019 Us Chs Consumerism Global
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The role consumers play in managing their care is key
to reducing costs or health care systems. The majority
o these o system costs are avoidable i consumers live
healthier lives and adhere to treatment recommendations
when diagnosed. To achieve optimal consumerism in
a health care system, leaders must provide tools and
incentives that reward appropriate behaviors by consumers
working in tandem with their providers via a guided
sel-care management strategy. A health care systemaligned with consumerism will likely see costs reduced
and satisaction improve i it transitions rom a patient-
orientation to consumer model o care.
The ndings suggest that consumers who interact daily
with health care systems share many concerns: costs
are problematic, comparisons o hospital and physician
quality is modest and disappointing, and understanding o
respective health care systems is low.
To engage consumers as active participants in their
health and to align their spending with system goals
o improved health status and lower costs, politicalleaders, hospitals and physicians, and policy makers
will need to address three major challenges:
Consumer awareness and understanding: The
capture and dissemination o inormation about system
perormance quality, satisaction, prices, provider
adherence to evidence-based practices, and consumer
adherence to personalized health plans is necessarily
a high priority or each system. Useul report cards that
gauge system perormance must be developed and
made accessible to providers and consumers. Regulators
and health plans should align nancial incentives with
optimal perormance in the key areas measured. This
eort will require investments in inormation systems
and operational procedures, as well as regulatory
changes that support transparency, to evaluate the
perormance o each countrys health care system.
Sel-care support and health coaching: Chronic
illnesses are prevalent in all six countries. The majority
o consumers say they need help in managing their
diagnosis, but use o inormation technologies to
deliver coaching and sel-care support to consumers
is lacking. These cost-eective tools are not perceived
as being readily accessible to the population. As a
result, avoidable costs are increasing. Social media,
online tools, and emergent administrative and clinicalinormation applications that eliminate paperwork,
redundant testing and delayed access to diagnostic
test results will be essential investments. Capitalizing on
these eorts will be a key priority.
Strategic investment: Political priorities oten
challenge investments in health care system
transormation. However, the rate o system spend ing
growth poses a scal challenge to these countries.
The reality is that substantial investment is needed
to reduce health care system costs while improving
perormance. These investments are ront-end loaded
but pay long-term dividends. A concerted campaign totransition rom patient passivity to active engagement o
consumers will require political leadership and vision.
This report highlights consumer similarities and dierences in
health care systems that vary by design and cost. However,
surveyed consumers in all systems experience pressure to
pay or their portion o health care costs (even in systems
that are ully unded by the government). They also see
a common need or improved service and increased
transparency in their systems.
The opportunity exists to improve each o these health care
systems. Engaging consumers as active participants in the
process is a key component or success.
Implications
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23/242010 Global Survey o Health Care Consumers 23
Authors
We would like to recognize the individuals who contributed their insights and support to this research.
Paul H. Keckley, PhD
Executive Director
Deloitte Center or Health Solutions
Deloitte LLP
Dean Arnold
DTT Health Care Sector Leader
Deloitte Touche Tohmatsu
Thomas Northo
Partner, Lie Sciences & Health Care Leader
Deloitte Consulting GmbH
Yves Jarlaud
Partner, Lie Sciences & Health Care Leader
Deloitte Conseil
Robert Reppas
Partner
Deloitte AG
Mark Fam, CHE, MHA
Senior Fellow
Deloitte Center or Health Solutions
Deloitte Consulting LLP
Acknowledgements
In addition to the authors above, we would like to thank Joyce Ehrlich, Jennier Bohn, Patsy Bolduc, Helen Baxter,
Erwan Lamour and Janett Reidel or their leadership, as well as Bianca Chung, Michael Curtis, Malay Gandhi, and My Di Le
or their contributions.
Contacts
8/6/2019 Us Chs Consumerism Global
24/24
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