From Health Consumer to Health Citizen

This is the follow on book, Health Citizenship, by Jane Sarasohn-Kahn @healthythinker and health economist focused on consumerism and a friend and colleague for many years. Her previous book, Health Consuming, talked about the evolution of consumerism in healthcare and asked the question, "What if people in America were health citizens...?" But what does it mean to be a Health Citizen? Certainly more than a consumer. The concept is more common in Europe but Jane sees the opportunity to move from being a consumer of health to a full citizen, controlling not only where one receives care (such as, in retail pharmacies and big box stores) but negotiating health and wellness through digital tools, making the home a health hub.

She defines the four pillars of health citizenship: Health security, Trust, Digital Citizenship and The new social contract. Health security involves the ability to receive care with reliable health insurance and without the fear of high deductibles and bankruptcy. Trust is a key concept which has been somewhat eroded for healthcare in recent years. Digital citizenship is beginning to be realized in many areas of life which is lagging in healthcare but due to the pandemic, may be changing faster (10 years of change in 2 weeks).

In the wake of the coronavirus pandemic, consumers' trust and belief across the healthcare ecosystem has grown - and especially for health care providers, whose heroism in the crisis has been on vivid, dramatic display in the local and national media.

Finally, the new social contract, which she defines as "masks and love", a move toward healthcare as a right. This ties into her discussion of Don Berwick's concept of the Moral Determinants of Health, understanding and addressing the victims of inequality in health. Also in this new social contract also is reflected in ESG investment (Environmental, social and corporate governance) or "who cares, wins."

Punctuated with her in depth references to survey data from Accenture to Edelman to Kaiser Family Foundation and others, this well-referenced work also includes pithy concepts like "pandemic pantries", Self-care as healthcare DIY", and "The She-Cession". Definitely worth the read as we move from another pandemic surge to a hopeful, vaccine future.