60% Think We Are Headed To A Depression

You wonder how bad it is economically or where we are headed…look no further than the CNN poll out this morning showing that 60% of Americans think it is likely that we will go into a depression.  Not a recession, but a depression like many of us read about in the history book or saw in the movies.

Do people really know what the depression meant – 25% unemployment (for example).  So, if that’s the perception out there, imagine the impact on health behavior.  People will continue to look for savings opportunities – skipping pills, splitting pills, moving to generics, trying over-the-counter medications, moving to mail order.  They will likely be less likely to act preventatively – e.g., getting a flu shot.  They may be more willing to ride out bad symptoms at home rather than rush to the clinic.

This makes me think about an article I saw the other day that said that people don’t have any solutions to manage trend.  I think that’s BS.  The fact is people are afraid of the solutions to manage trend.  They don’t want to tell employees what to do or limit their choice.  In a tight labor market, companies want to keep the employees happy.  So, as the labor market opens up (i.e., higher unemployment) and healthcare costs go up, will companies finally embrace some of these tools.

For example, on the pharmacy side, we used to see a spike in call center volume of 1,000%+ on some of the aggressive programs – mandatory mail, step therapy, limited formulary, limited retail network.  That scared a lot of clients.  Maybe that attitude will change.  Granted pharmacy is 10% of medical spend so the bigger problem is on that side, but maybe companies will finally be willing to link out-of-pocket costs to controllable medical activities – weight, exercise, blood sugar, cholesterol, preventative testing.

If I were a insurer or a PBM, I would be focused on showing my value right now.  I would be delivering cost savings messages to all my members and help them understand how to minimize their out-of-pocket spend in this economy.