The United States' Health Care Consumer Behavior: Making Economic Decisions

The United States' Health Care Consumer Behavior

Making Economic Decisions

Chandler Jones, MSHA, RRT, RRT-ACCS, RRT-NPS, CPFT

05/10/2021

Author Note

            Chandler Jones

            I have no known conflicts of interest to disclose.

            Correspondence concerning this article should be addressed to Chandler Jones

Email: [email protected]

Abstract

Healthcare is constantly moving and is a significant catalyst in terms of American finances. Health care consists of, well, people. People have beliefs, cultures, attitudes, and a vast array of opinions regarding medicine. Many of these variables dictate how patients, or consumers, use health care. Consumer behavior is one method of manipulating the health care market to benefit the organization as well as the patient. Research shows that the many healthcare trends set forth a solid approach to challenge the changing environment of medicine. Three questions will be answered: do consumers behave in predictable patterns, can these patterns be used to make economic decisions, and can this information be used to enhance the prospects of future sustainability. This entry will dive into the realms of healthcare's financial infrastructure and how understanding health care consumer behavior can enhance and provide suggestions in terms of future economic decision-making and sustainability.

Keywords: healthcare, consumer, economics, behavior, sustainability.

The United States Health Care Consumer Behavior: Making Economic Decisions

Though shaped through time and by chance, American culture and behavior play a tremendous role in how Americans approach, utilize, and carry out medical care. Marsch (2021) explained that "human behavior is one of the biggest drivers of health and wellness as well as mortality and morbidity" (Para. 1). It was set out to determine if consumers behave in predictable patterns, if these patterns can be used to make economic decisions and if the information can enhance future sustainability prospects. This entry will dive into the economic realms of healthcare's financial infrastructure as well as how understanding health care consumer behavior can enhance and provide suggestions in terms of future economic decision making and sustainability.

Change is the nature of American health care, and this change can come in the form of health technology, evidence-based medicine, insurance coverage, policy change, defensive and wasteful medicine, and many more; the majority of these changes, as the data explains, have significantly increased the toll on this expenditure (Dieleman et al., 2017; Shi & Singh, 2019; Nelson & Staggers, 2018). As a result, countless research articles in circulation attempt to explain how policy, healthcare reform, insurance stipulations, and more influence the costs seen in the American health care system. 

The fact of the matter is that the Unite States's current health care expenditure was at an all-time high of 17.7% in 2019, with predictions of climbing to 20% and more significant (McCarthy, 2015; Shi & Singh, 2019). In addition, Medicare and Medicaid are constantly on the verge of bankruptcy; life expectancy, patient outcomes, and patient satisfaction rank low compared to other nations (Ta et al., 2020; Shi & Singh, 2019). Thus, looking through another lens may provide insight into how the patients themselves influence healthcare economics. The following is a brief overview of some of the issues that affect the economics of health care and patient behavior. 

Financial Structure

            The financial structure is similar to how all other businesses obtain assets and profits. The most significant difference between healthcare and, say, Amazon is that healthcare must not only make enough money to keep the facility afloat, pay health care providers, and market, it has to take into account disease outcomes. In a way, it is quantifying outcomes outcome concerning profits. According to Lee (2019), Shi and Singh (2019), the American healthcare system encompasses government-run or privately owned financial designs. They can be for-profit or not-for-profit (nonprofit). For-profit facilities do just that; they try and make a profit. Nonprofits, contrary to belief, make profits – they just do not pay taxes. However, categorized as a 501(c)3 under the IRS as tax-exempt, these facilities have an obligation to prove that the taxes not paid (profit) are being used to benefit the community. 

Government-run hospitals (federal and state) encompass roughly 200 facilities in the United States and are overseen by defense departments, health, and human services, veterans" health administration (Liu & Kelz, 2018). State facilities and policies contribute tremendous amounts of resources to the health care system. Vogenburg and Santilli (2019) pointed out that “the multiyear shifting of federal controls over select healthcare-related decision-making has emboldened state legislatures to act when Congress has been unable to do" (p. 349). Some of these programs, such as the repayment reconciliation model, aim to create an environment where patients can trust that governing bodies look out for their health and financial status. This builds an initial yet useable amount of transparency, trust, and utility regarding the health care industry as well as providers.

Dissemination of Health Technology

            The diffusion of health-related technology is by far one of the most influential factors in the rising prices of healthcare. However, American culture dictates its use (Eaves et al., 2020; Shi & Singh, 2019). Healthcare technology is essentially being adopted and implemented unimpeded, driving up the costs or many procedures up. This is not to say that it also is not saving money in some sectors. It also has the ability to increase access in some ways. For instance, some minor surgical procedures that were once performed in the hospital facility – usually including a"  "observational st" – are now able to be performed in an outpatient manner. On the back end, this does save some associated costs.

In the same way, health technology may decrease the use of some equipment such as needles. For example, point of care ultrasound (POCUS) decreases needle sticks and infection rates significantly when used by trained professionals. However, the equipment used to perform this is expensive, and the return on investment may take some time. A vast majority of the population accepts health technology to enhance care, access, and personalization. This can adoption behavior can be observed today as many companies, even though not FDA regulated, release wearable and integrative health technology. 

Medical Practice

            It was stated that 60-90% of physicians and physician extenders practice defensive medicine (Cai et al., 2020). This concept is a self-protective measure taken to limit litigation based on malpractice and the like. Although there are alternative dispute resolutions, such as mediation, billions of dollars are spent fighting legal battles (Pozgar, 2018). Not only do the legal bills expand on the health expenditure, but the frivolous use of equipment is also a factor. Thus, waste and abuse of medical equipment, medications, staff, and insurance come with legal issues and monetary issues. This aspect, among many others, decreases public trust in hospital facilities and physicians.

            All of these variables influence not only the financial sectors of healthcare but the patient population as well. These few variables shape the way in which customers approach healthcare. Current healthcare costs are monumentally, and the way consumers react to the constant changes is based on several behavioral, social, and environmental factors: culture, socioeconomic stance, and cognition. 

Consumer Behavior

            America has a natural tendency to provide the best and most efficient products on the market. In this way, Americans expect this in every aspect of the consumer market, and healthcare is no exception. However, there are variables outside of the cultural entitlement that influence patient interaction with health care and influence behavior that brings them closer. One method of determining consumer behavior is behavioral reasoning theory (BRT). According to Sahu et al. (2020), this concept can be used to determine the relationship between beliefs as well as values. It can also be used to understand why customers are for or against a service or product (Sahu et al., 2020). BRT breaks down the attitude associated with the reasoning, the subjective norms. This mode of evaluation takes into account reasons for and reasons against measures, in context to using cognitive pathways, consumer behavior (Sahu et al., 2020). 

Socioeconomic Factors and Culture

Among the many variables determining health care consumer behavior, socioeconomic standing is one of the most significant cofactors present (Sheehy-Skeffington, 2020). 

The Affordable Care Act, implemented in March of 2010, opened many doors for those previously unable to seek medical care. There were essentially three main goals associated with this law: make health insurance, thus medical care, more affordable, expand Medicaid to cover those that live 138% below the federal poverty level, and support the creation and implementation of innovative medical care to lower costs (Shi & Singh, 2019; Affordable Care Act [ACA], n.d.). However, though access is still limited in some areas and healthcare disparities still exist, this reform flooded the market with new health care consumers (Barlas, 2014). 

One behavior that is evident in the United States is spending. This flooding of the market is a result of access at an affordable price. It also led to a spike in the health technology/information sector. These innovative and cost-effective modes of delivery are a staple in American healthcare. Americans want the best, most effective, and, frankly, the most expensive treatment they can find. The belief is that if it costs more, then it must be better. 

            Another observed behavior regarding healthcare-associated behavior is the relationship between the provider, patient, and the establishment. Many providers practice in a system where volume trumps quality. Many providers are paid based on the number of patients they see. To the consumer, this leaves them feeling uncared for and without understanding. Hardy (2021) found that, not only because of COVID-19, telehealth patients were generally happier due to longer allocated times that let them speak and interact with the provider than a traditional facility. When patients do not feel as if they are cared for, their behavior may change in that they underutilize or do not utilize healthcare modalities.

            Those who live below the poverty line are more likely to engage in health risk behavior than those who are not. In the same way, those with less income generally have lesser access to health care, compounding the fact that their health is at risk. Eaves et al. (2020) stated that there are still many hurdles to overcome when considering the less fortunate in financial standings. This behavior is predictable.

Environmental Factors

Convenience tends to mold behavior as well, as can be ascertained from the statements over telehealth. Mou and Shin (2018) explained that the implementation of wearable health care technology has been increasing substantially throughout the years. This can be attributed to many factors, such as the busy lifestyle of Americans or the general aging population with increasing limitations on mobility. As these wearable technologies become smaller, more advanced, more integrative, and integrated, not only will the behavior of the patient population change, but the whole of health care will be impacted. This is not to say that healthcare can be 100% carried out on a watch or even in the home. Some consumers may still opt for in-person visits, and, of course, a number of situations will warrant visits to providers. This plays on the need for recognition of the technologically advanced and growing healthcare consumer market and is undoubtedly a behavior to utilize in the coming years (Qazzafi, 2019). 

Aging a significant factor in how medical practice is shaped. According to several experts, the aging population consumes more health care than any other demographic and requires more extended amounts of care as well (Shi &Singh, 2019; Harrington, 2021; Lee, 2019; Nelson & Staggers, 2018). Chronic disease is a devastating drain on the health field. However much one can elaborate on this subject, the fix may be near. Genetic implementation can decrease chronic disease burdens (Bergquist & Lobelo, 2018). Diseases such as cystic fibrosis, arthritis, scleroderma, and many more could, essentially, be eliminated from the gene pool. The saving associated with this type of personalized care would be tremendous. However, many individuals, certainly including the elderly population, are skeptical about this form of treatment. Because of this, implementation and use would work economically in the negative (at first).

Cognition

            Perception, attitude, and values place a more in-depth meaning on healthcare-associated behavior. Perception is a mental impression, perhaps from an earlier time or upon the first encounter. It is a way of understanding something. Healthcarconsumers'" perception of providers, facilities, and the services/products they are purchasing shapes how the process occurs. For instance, if an individual has a bad mental image of doctors, they may not trust doctors, hospitals, or general allopathic/osteopathic medicine. This generally limits the use of health care services until a problem proceeds to a level of implied consent.

In the same way, attitude places the patient in a specific frame of mind that may positively or negatively impact their relationship with healthcare. This may occur as a result of personal experience with the hospital, with the provider, or with the industry as a whole. Values tend to shape how important we believe something to be – an example being individuals that show up to work on time and feel anxiety when being late. They value the concept of time and upholding obligations. 

            Each of these variables plays a vital role in behavior, as stated above. If a patient does not value themselves or have a preconceived image of themselves, this can manifest as a healthy or unhealthy lifestyle, i.e., people who do not value themselves may become obese (Hill, 2017). In the same way, if people do not value health care, they simply will not interact with it or acknowledge its importance until a situation becomes dire. 

Current Trends and Future Outlook

             As noted in the beginning, the general current trends are not in favor of relaxing expenditure. The future, as it stands now, is uncertain for many aspects of care and affordability. However, there are innovative approaches that show promise. The market is in a constant state of flux, with constant changes to the literature, to the practice, to the policy, providers, patients, and, well, behavior. The literature impacts the providers, in turn impacting the policy and the practice. All of these changes impact the patient and their behaviors. 

            When literature is published, after critical review, of course, providers then begin to adopt it. However, this is not all at once. Say, for instance, a patient is brought in for surgery and then finds out that there is a new, more effective, and safer procedure. Although this is not the provider's fault or the facility's, the patient may then feel as if they were taken advantage of or lied to. This breeds a negative attitude towards health care and pushes patients away. However, once a novel practice has entered the field and is deemed a standard of care, it generally spurs an influx of new and needy patients and is adopted rapidly. This can be commonly observed in the pharmaceutical industry (Joszt & Caffrey, 2020).

            When these therapies and procedures are implemented, it changed policy in some instances; this can be related to insurance or facility-wide policy. When novel therapies are introduced, insurance companies may not initially cover it, turning individuals away from medical care. On the other hand, if it does cover these types of therapies, there will be an influx of those that need it, thus driving up premiums in the long run. Those that understand this usually opt for a known, covered, and effective therapy. These higher premiums also influence behavior in that those that have higher premiums and deductibles are less likely to seek medical care unless needed.  

            Of the many factors that influence decisions and the use of health care, all of them increase costs. However, there are a number of innovative approaches to health care that will not only change consumer and physician behavior but in a way that facilitates savings and improved patient outcomes. Allowing patients more autonomy in their care, expanding value-based insurance coverage as well as other innovative coverage options, and implementing wearable technologies are all behavior-positive proactive steps to decrease costs and stimulate the health care economy. 

            Patient autonomy is a direct result of consumers' behavioral traits, but it also enhances their care. Skagerstrom et al. (2017) resulted research that showed patient involvement with decision making led to safer care. When patients have a voice in their care, especially when it is backed with solid evidence of improved care, they are more likely to seek care that encompasses this concept. A consumer who feels as if they have a choice in their care is more likely to seek medical attention and follow through with compliance and adherence (Skagerstrom et al., 2017). One of the essential concepts to be integrated is that of personal health records (PHR). This is a way for patients to get more involved with their care without compromising the actual care being delivered. For instance, patients are able to keep a data log of their daily health status, feelings, and the like, similar to a journal with an in-depth health-related format. In the same way, patients are able to access their files at any given time, allowed to share at any given time, and decrease instances of information gaps and needless expenditure in regard to treatments such as duplicate laboratory visits.

            Shi and Singh (2019) pointed out that although the cost of healthcare outweighs all other nations. Value-based repayment programs, readmission reduction programs, and personalized medicine are three of many programs that are shaping the future. They are essential to rebalancing the patient-physician relationship, decreasing costs, and improving the trust between the two parties, as well as the insurance providers (Hirpa et al., 2020). This change in attitude, or perception, can influence consumer behavior in that once individuals begin to see the benefit and improved outcomes, they will utilize healthcare in a more responsible, cost-effective way. Programs such as those mentioned, as well as accountable care organizations, bring about a type of practice that incentives the physician for improving thpatient'sss health. For instance, if a patient currently enrolled in a conventional health insurance program maintains a high or abnormal A1C level, the company may jus"  ""keep an eye on i""" Value-based programs emphasize improved outcomes and pay the physician, speaking on the previous scenario, a bonus for lowering thpatient'sss A1C. 

            It is, in fact, something of a sci-fi movie; consumers want their healthcare to travel with them (Zhang et al., 2017). These concepts are already in motion with wearables such as Fitbit and the Apple Watch. These devices can monitor heart rate, oxygen saturation, blood sugar; some of them can even print off an electrocardiogram strip and much more. This will be a new wave of technology once all of these gray areas and bugs are sorted out. Not only does this change medicine, but it also changes the customer's behavior. It gets them more involved and allows them to monitor progress as they move through programs. Some of these devices allow consumers to set alarms, goals and save data. However, with the majority of technological devices, they can be hacked or lost, exposing sensitive patient information. Given the current uncertainty of the times, aindividual'sss attitudes may justify not participating in wearable health technology. In some stances, it may just be too expensive, and not until there is coverage for such actions will many not be able to, even if they want to.  

Artificial intelligence (A.I.) in health care is something that puts many people on edge. Marsch (2021) explained that the digital health revolution is transforming the world, not just the United States. Artificial intelligence brings about an opportunity to enhance care but also collect data about health-consumer behavior. Abbott (2020) explained that the Google-developed AI DeepMind has detected more cases of different types of cancer, reducing missed cases by 9.4%, and incorrect positive cases by 5.7% compared to trained physicians. This is saying that 5.7% of those diagnosed with cancer and follow through with care do so in vain, costing hundreds of thousands, if not millions of dollars to the patient and billions to the infrastructure. A.I. can be implemented in other ways as well. For instance, Lemonade is a majorly AI-run insurance company that has been trending in the market. No, this is not the A.I. people speak to before asking for the representative; it is algorithm-based insurance plans that are individualized for the patient and now, pets.

These future trends hold tremendous value in shaping healthcare for the better, building trust, encouraging healthier lifestyles, better patient-provider relationships, and concluding with higher qualities of care with a linear decrease in healthcare costs. Commitment to following through with these future endeavors will establish a foothold and eventually a possible solution to the problems Americans encounter in medicine. Healthcare sustainability blooms from this statement, but it is the behaviors that make it a possibility.

Sustainability

The concept of full-blown, or close to, full sustainability is a measure of people'sss ingenuity and tenacity. There are many variables to consider when determining sustainability: employees, resources, quality, infrastructure, healthcare coverage, and more (Nicol, 2018). Nicol (2018) stated that protecting and ensuring staff well-being is one of the most critical aspects of sustainability. However, this comes down to, again, another set of variables, such as leadership style, policy adherence, and benefits. Patient safety is a quality concern. This involves ever-shifting variables. As we have seen so far in medicine, there is not a perfect drug or a perfect provider, procedure, tool, or any other variable. When it comes to policy and coverage, as was stated before, moves are being made to address the gaps that are observed with the Affordable Care Act. Value-based care organizations, personalized healthcare, accountable care organizations, and the like are marking a trail for future coverage endeavors (Shi & Singh, 2019; King, 2020). They all impact how the consumer interacts with healthcare as well.

Employees such as respiratory therapists, nurses, sonographers, and the like create the foundation on which providers work. Providers are not the boss. The administration has an obligation to start the trend of honest and open communication, the key to creating sound employee interactions. Patients notice how employees are treated. If an institution does not value its employees, it speaks volumes regarding how they must feel about patients. This brings about the notion of mistrust, lack of safety and breeds an overall perception that the healthcare facility (which would manifest as all facilities and the practice) essentially does not care about the consumer. 

Patient safety and satisfaction are one of them, if not the most, important aspects of health care sustainability. Healthcare facilities can be built, but if patients know they are not safe or know that they will not be satisfied with the care, they will not use it. The concept of patient safety is the undertone of a successful healthcare organization. To add, patient safety is key to decreasing costs as well. Take, for instance, a situation in which a provider ignores safety policy and infects a patient with a communicable disease. This could cost the facility millions of dollars in lost pay-outs and loss of resources (Slawomirski et al., 2017). Understanding the relationship between patient satisfaction and health-behavior use is predictable and highly impactful in terms of economic stability. 

Policy, as was stated, plays an important role in not only access but costs. There are a number of cases in which even those that are covered by insurance do not seek care due to costs (Han et al., 2015). Costs are one of the main drivers in how patients interact with health care. Healthcare use based on how much it costs is certainly predictable. The reform noticed drifts today from general volume-based care to innovative value-based care systems. 

As was stated previously, genetic intervention is one way to eliminate some diseases. However, there are many limitations to the expansion of the implementation of genetic medicine as an affordable norm. Regardless of this fact, it holds a promising future. Though many stakeholders would disagree, imagine a world in which diseases can be easy to treat, and better yet, easier to cure and eliminate. Sustainability would be as simple as fixing a gene. Of course, this is something possible well into the future, but it has some severe economic positives.

People are concerned with genetic intervention. This is due primarily to a lack of information and knowledge on the matter. Dissemination of information can change many behaviors associated with genetic" tinkering." Fear creates avoiding behaviors, and many people would currently avoid this form of medicine. However, if restrictions and stigmas are lifted, more and more human trials are approved, this would be sought after. Take, for instance, someone that has heart disease; a simple stop to a genetically enhanced facility could potentially reverse or halt damage to the body. This satisfaction keeps the patients coming back to the same facility, seeking out the same physicians, and in turn, building a readily accessible, highly detailed health record.

RQ1: Are these consumer behaviors predictable?

            The majority of consumer behavior is predictable. Sheth (2020) stated that consumers are predictable and, over time, develop specific habits. Northeastern University also published a similar article in 2010 that stated that human behavior could be predicted 93% of the time (Para. 1). With this being said, there is a vast amount of literature to turn to when determining not only human but consumer behavior. In relation to the mentioned variables, this should be so. If an individual does not have the funds to pay for the care, it makes sense that they will not seek medical attention.

In the same way, if the patient does not have the proper access, they may not have the option to seek a provider. Consumers that do not trust the product they are considering purchasing may opt for alternative routes of care. Comparatively, if patients negatively perceive providers, health care facilities, or the practice, they will not seek care. The same can be said for attitude as well. 

            Convenience for a bargain is essentially the key to establishing a high-functioning health care system. Based on the statements mentioned above, it can be predicted that the more accessible, the higher the quality, and the lower the price, the more people will seek healthcare and vice/versa. Healthcare operates in an inelastic nature (Lee, 2019). Price may not have everything to do with how healthcare is used, but it does somewhat dictate which facility is able to provide the desired care. For instance, during COVID-19, personal protective equipment was an elastic market. Though it is a considerable portion of health care operations, demand sent the costs skyrocketing to 100%, 200%, and more significant than the original price. This limited the quality of care provided to many patients. Some facilities even reused gowns or did not switch gowns between patients.

RQ2: If there are predictable patterns, can they be used to make economic decisions?

            As stated earlier, health care is essentially inelastic, and prices generally do not impact demand, this being a general statement. However, use does impact the economy. Onge and Krueger (2017) segmented health behavior by region, class, income, health-promotive, and health-risk behaviors, amount of sleep, and demographics. This research, and others like it, provide a framework to disseminate the information needed to predict specific patterns. For instance, Onge and Krueger (2017) pointed out that the lower socioeconomic class are of the most at-risk population for engaging in acts such as smoking and drug use. Using the stratification of behavior, one can probe into how these behaviors can be manipulated to enhance their health, decrease costs, and produce profits to keep facilities afloat. 

            It is a known fact that those that live in poverty generally engage in risky behavior, and this fact alone is usable. Products such as tobacco and alcohol are elastic products. This is to say that price impacts demand and vice/versa (Lee, 2019). Healthcare legislatures have tremendous power to persuade other industries. Increasing taxes paid, or the prices in general, of these harmful products, can decrease their use in some circles. Although this has ethical implications, such as allocating these products in a way that only wealth can afford them, it is beneficial to the general population. Decreasing the number of those using these products, though it would take some time, could potentially increase population health and ease some of the disease burdens (such as COPD and Cirrhosis) that the healthcare industry is plagued with. In this way, improved health decreases overall costs, allowing for allocating funds into other regions of the system. Onge and Krueger (2017) concluded that "individual behaviors tend to group together by health behavior typologies into meaningful health lifestyles that are anchored in social circumstances" (p. 96). It can be argued that behavior is an essential tool in determining how to go about economic endeavors. 

            Knowing that there is a population of patients that require specific care, it is also found that once therapy is available, those that are able to seek it fervently. Sheth (2020) pointed out that pent-up demand occurs when a market is denied for a period of time. Decrease some disease burdens, as stated above, can free up funding for other needed aspects of care. As this progress continues, lowering disease burden with value-based care, the new therapy is released and is all cost-effective, more and more people will begin to enroll in the system. Once the majority of diseases are managed appropriately, one can make the assumption that costs would level off, providing even more cost-effective decisions and improvements.

            Technology is something that patients are in favor of. This is evident when reviewing the spike in healthcare costs in relation to the technological boom. Telehealth is a good investment in healthcare. Not only this, Medicare and Medicaid have been expanding and changing their scope to involve more and more healthcare personal as to reach more and more patients. For instance, some people have diseases that limit their mobility, only using it when the need is dire. The emergency room is the first place they think of, and as Shi and Singh (2019) pointed out, it is the most expensive route in healthcare. Using technology such as telehealth or wearable devices can provide healthcare professionals with the information to aid in avoiding emergency room visits. As it stands, technology is one of the main reasons health care costs are so high. However, one can argue that, based on health-behavior trends, especially as the years move forward, technology can redeem itself. Economically speaking, this is something that can happen quickly and provide a high level of care.

RQ3: Can patterns of behavior be used to create a self-sustaining healthcare system?

            It could not be determined if sustainability is obtainable. Though there are many research articles that pose this question, the answer remains elusive. Here it is postulated that the system is just too large, encompassing too many variables, and it would take a tremendous amount of effort over an extended amount of time to reposition each variable to provide the most significant, most cost-effect care as well as retain reusable, renewable, and quality resources. Braithwaite et al. (2017) explained that this is an enduring problem for everyone involved with healthcare due to the various factors involved. This is not to say policymakers and stakeholders cannot start now. Harris et al. (2020) provide literature in regard to resource sharing and doing so effectively. Resources include employees to the greatest extent and supply in another – their idea is to integrate"  "consumer values and preferences in decision making for resource allocation" (p. 323). Many proposed theories exist regarding healthcare sustainability. This conundrum is one that many are moving towards. This is evident in the number of publications on the matter over the years (Braithwaite et al., 2017).

Conclusion

            Several points have been made here. First, health care is in a state of unimaginable stress. Its economic impacts are felt in the United States as well as the rest of the world. More is spent on health care than any other nation in the world without expecting results. People have lost faith in the system – some feel jaded, mislead, swindled, and even battered. In relation to how much is spent on health care, health care disparities are still very real, very impactful, and felt in all nations. Healthcare-related technologies have largely pushed this expenditure up. Those elasticities play a considerable role in the majority of markets; health care is different and creates a situation in which it feels as if there is no way to get above the metaphorical water. 

Of the number of factors relevant to health care, health-related behavior is a vast concept that has even more critical elements to it. According to experts, human behavior is largely predictable. This poses the question as to why health care is the way that it is. If industry knows that a particular population is eager to spend (in one form or another) large sums for the most significant technology, why wouldn't they ramp up production, market it to those individuals, and reap the benefits? It is hard to say if this is the true nature of the problem. However, there are programs in a process that eliminate this threat to some extent. Accountable care organizations, value-based incentive programs, and the like are all in line to eliminate this factor, as well as many others. To add to these programs is artificial intelligence. Though skeptical, patients can benefit from these learning machines. Of course, there will always be a need for health professionals, but allowing A.I. to participate in diagnosis, data entry, financial predictions, and more can only add another, much more calculated and less biased layer to the healthcare industry. 

The American population, its self, is acting a restrictive disease. As health care improves, these patients get older, needing more from the system, essentially strangling the growth. Their behavior dictates a portion of the entire health care system. This is not to say that the elderly must be forgotten. This is just saying something must be done. As stated earlier, one approach is the implementation of genetic interventions. The American economic structure can thrive with the elimination of diseases such as cystic fibrosis and arthritis. Unfortunately, behavior towards genetic intervention is on the negative spectrum as many are unsure. This mistrust in the system, the providers, and the practice will hold it down until significant breakthroughs. The mentality of the population, specifically the elderly, is one of caution towards this type of care. 

Finally, sustainability; is the ultimate goal. A thriving, self-replacing, self-controlling health care environment, though it is difficult to envision this as a future norm, it is not out of reach just yet. There is a movement towards sustainability, though it is not quite set in stone how exactly that is achieved. Predicting and utilizing health care consumer behavior should be one of the founding pillars of this type of system. Understanding how costs, perception, attitude, spending habits, attitudes, trust, and the plethora of variables that are already established work is one way to create a functional, wasteless health care system; one that can provide better care for cheaper costs, better access, and compelling technological adoption. In the same way, providing the appropriate amount of time with the provider, the patient, and the education sessions can provide the system with informed decisions, not so much blind faith in the system to not the patient fall through the cracks of this financial behemoth. 

This entry attempted to explain why some behaviors may manifest, how certain behaviors and cognitive processes hinder or help the institution and the patient, and how this can be used to create a self-sustaining industry and effectively eliminate many of the problems, including diseases, observed today. It is evident that these behavior patterns can be used to make future economic decisions. This article is a drop in the ever-expanding ocean of research on the matter. Action will yield results, as we have witnessed with many of the endeavors seen in the currently evolving system. In the state that the health system is already in, proactive actions are the only chance the United States has in terms of turning this around. When will it be too late to turn around, the economics skewed past the hopes of help? With a fast understanding of behavior, this is possible. Maybe not at this very moment, but gradually over time.

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