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The Big Story: Economic Well-Being of U.S. Households in 2022 – The Federal Reserve

More voters skipped the doctor last year because of the high cost of care.

“Many voters went without medical care in the prior 12 months because of the cost. Twenty-eight percent of adults went without some form of medical care in 2022 because they could not afford it…The likelihood of skipping medical care because of cost was strongly related to family income.”

What it Means for You

By David Jarrard
3-minute read

Actually, the report doesn’t say “voters.” It says “Americans.”

But read the survey of more than 11,000 people through the eyes of your Congressional delegation. Or your governor. Know that voters named “reducing healthcare costs” as the second-highest priority (just behind “strengthening the economy”) when asked by the Pew Research Center to rank policy priorities.

The issue spans the political spectrum. In today’s fractured, tribalized environment, doing something to rein in the cost of care is a rare, unifying, politically safe issue for lawmakers on both sides of the aisle.

Now here they come in a student body rush to use their legislative, regulatory and purse-string powers to get the cost of care under control. In this intent, they are not wrong, of course.

Who’s standing in the spotlight? You, as a healthcare leader, along with your organization. Alone, in the middle of a giant bullseye, like Wile E. Coyote having another bad day.

“This is all about greed and money,” says Democratic Massachusetts State Senator Cindy Friedman, who chairs the state legislature’s Joint Committee on Health Care Financing. “I have no problem with people making a profit. I really don’t. But there’s profit, and then there’s obscenity.”

Ah, you might think. She must be talking about health insurance companies, like UnitedHealth Group, which reported a $5.6 billion first-quarter profit as revenue jumped 15 percent to nearly $92 billion in the first three months of 2023.

No. She’s talking about hospitals.

“People are so afraid to touch this because [hospitals] are the economic engines,” she continues. “It’s a business, and people are making huge amounts of money…That’s what you’re up against.”

Not to single out Sen. Friedman. She’s echoing the sentiment expressed by lawmakers across the country and in our nation’s capital, too. From a variety of political corners, hospitals are loudly accused of charging too much, gaming funding systems for their own gain and offering too little to their communities in return.

The lawmakers aren’t coming to this conclusion unaided. Rachel Cohrs’ investigative article last week in STAT is headlined in part: “A cadre of billionaires is mounting an unorthodox campaign against hospitals.” (Much of STAT is paywalled, but the quality journalism is worth the price of admission.)

Cohrs writes that there is “a small club of wealthy philanthropists using unorthodox tactics — and piles of cash and connections — to mount a campaign to rein in hospital prices. They’re buying Super Bowl ad spots, bringing celebrities to Capitol Hill, bankrolling research at reputable institutions, and financing small advocacy groups across the country.” Want an example? Read this.

“Already,” Cohrs adds, “their priorities are gaining some momentum on Capitol Hill. So far this year, key committees in the House of Representatives have held half a dozen hearings examining the community benefits nonprofit hospitals provide, interrogating hospital markets, and considering aggressive legislation that would force hospitals to share their prices and change how they get paid by Medicare.”

It’s in this hothouse environment that Congress has called hospital leaders to hearings to explain themselves in what is the exposition of a classic DC story – one that’s sure to lead to legislative activity this summer to climax in new rules and laws this fall positioned to rein in the cost of care and to hurt health systems in the denouement.

The great grassroots power of providers

Hospitals, health systems and other organizations that deliver care are not politically powerless.

Indeed, the very political exposure that places providers in the middle of that bullseye – the daily, point-of-sale, personal engagement by millions of caregivers with millions of patients – is the fertile soil for growing great political strength. Grassroots strength.

When “voters” think about healthcare, they think of providers first. The industry has spent a hundred years and countless dollars on branding and buildings to ensure this very position. You’re running the ads. You’re sending the bills. You have thousands of employees in your community, wearing your logo. So, when consumers think about reining in healthcare costs, you’re top of mind, too. Congratulations.

This vulnerability is also the source of a provider’s political strength. Your organization serves hundreds or thousands of “voters” (and their families, by extension) every day.

You employ voters, too, feeding the local economy not just through the economic cascade of payroll and contracts, but by being an institutional pillar that ensures other employers are attracted and remain in your communities.

It’s the hard work now of providers to rally, focus and deploy this political power. No other sector of the healthcare industry – not insurance, not pharma – has this potent potential.

You know the steps:

  • Develop your story that reflects your service, your accomplishments, your needs, and that speaks to the political moment. Anticipate the scrutiny and be ready with answers that educate and offer a path forward and not merely a feckless defense of the status quo or “What about them?” deflections.
  • Identify the right messengers for your message. One message may be best delivered by your board members, others by your physicians or nurses, others by your patients. Some, by all.
  • Rally and deploy your messengers, meeting the political moment. An effective grassroots campaign can be a hosted series of quiet coffee conversations, or a bumper-sticker, a candlelight vigil, an educational picket maelstrom.

There’s more to it, of course. You know that. This is hard, focused work (following years of hard, focused work), and it can seem a deeply frustrating distraction while you and your leadership team are just working to keep the darn doors open and enough nurses for your beds.

But the risk is real. The forces at play are substantial. A consequential story about hospitals is being told, whether we join it or not. Yet no other element of the healthcare industry can match the political platform of providers. If it’s put to work.

Contributors:Emme Baxter

Image Credit: Shannon Threadgill