Obamacare was supposed to increase the demand on the healthcare system by providing greater insurance coverage and affordable access to health care. The emphasis was on preventative care to help improve Americans' health and save money at the same time by catching and treating conditions before they progress.
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In many aspects, the strategy is working, but there are still too many Americans that are simply bypassing the care that they need. According to a recent survey by Zocdoc, half of millennials see a doctor less than once per year. Why should this be the case given the greater access and emphasis on preventative care? The Zocdoc survey found several reasons why.
- Work Obligations – This is the top reason that working Americans cancel or reschedule doctor visits. 48% of the survey respondents cancelled appointments because of scheduling conflicts (obviously making work the higher priority), and 15% could not afford to take a day off for whatever reason (no remaining vacation time, permission issues, etc.). However, one-third of respondents are motivated to visit the doctor when their illness forces them to miss work. The survey does not address the point, but we suspect bosses and co-workers intervene at some point. We have all experienced the sick colleague who is too busy to miss work with their cold or flu and ends up infecting half of the office.
- Self-Diagnosis – The Internet is a great tool in many ways, but unfortunately, it enables people to think they can diagnose and treat their own medical issues through Internet sites. 43% of respondents said that it is easier to diagnose and treat themselves than it is to see a doctor in a reasonable time, with women more likely to do so than men by a 46%-39% margin. That leads into the next category.
- Appointment Difficulties – People find that it is difficult to get in to see doctors, especially at the last minute. One-third of respondents avoid seeing the doctor for that reason. For those who do call and cannot get through, 26% will either wait several weeks to make another try or will simply give up. 25% would rather book online or through an app.
- Lack of Online Options – Online engagement is increasingly important to patients. Few doctors allow online booking, probably because systems aren’t sophisticated enough to know how much time you need for your visit without getting further information, yet 80% of respondents prefer the online convenience. E-mail or text reminders are preferred by 29% of the respondents to help in scheduling checkups in advance.
- Lack of Priority – For too many Americans, visiting the doctor just isn’t that important. People find health care a struggle because they are too busy to keep a checkup (42%). 80% hold off on their preventative care, and 90% hold off on their own care to focus on their children's care. People find it easier to keep up with things such as career goals, family obligations, social life — even their pet's health and household chores—compared to their own health.
Clearly, people are not prioritizing the value of preventative health care and are making short-term convenience-based decisions. The doctor only comes into play when we are too sick to ignore our condition, yet that makes scheduling even harder.
Fixing the problem will require some combination of education, attitude adjustment on the part of health consumers regarding preventative care, and accommodations by doctors to make the scheduling process more convenient. Opening up access via Obamacare is only part of the health care solution.