As Gen Z starts entering the professional workforce and acquiring political positions, their progressive and critical views of the US healthcare system come along with them. In recent history, the younger generation has become more and more concerned with healthcare issues – namely, Medicare expansion, abortion access, gender-affirming healthcare, and insulin prices. But in traditional American fashion, our healthcare system is so incoherently complicated that it practically takes a higher education degree to properly know how it functions. Despite this, Gen Z has demonstrated greater consciousness of the shortcomings and cost-inefficiency of the current US healthcare system [1].
One of the greatest issues with the United States healthcare system is that it’s financially focused on medical care, which is not the lead determinant of health [2]. Personal behaviors, social factors, and genetics/biology all play a larger role in health than medical care does, yet they all have smaller national expenditures than healthcare has [3]. This can potentially indicate that in the US, we disproportionately spend too much money on healthcare. However, Gen Z has taken steps to support this claim by asking their physicians more questions about their health behaviors and other social factors that may act as more significant determinants of health than the medical care that one receives [4].
One of the best ways to increase federal and private funding for social and behavioral health services is to decrease medical care spending. What is our generation's role in this complicated, but potentially effective process? Two answers emerge as potential solutions.
One way Gen Z can enact change as the next generation of doctors and physicians is by transitioning to a capitation payment system. Capitation is a salary-based system, whereas most physicians are currently paid by Fee-for-Service (FFS). FFS means that a physician is paid for every service that they provide a patient, regardless of its outcome. This means that physicians are financially incentivized to provide more care than necessary for a patient, which may in turn, decrease the quality of care. Being paid through capitation as opposed to through FFS eliminates the financial incentives for physicians to provide low-value care to their patients and shifts the incentive to provide more high-value care (biggest bang for your buck!) [5]. Increased high-value care means better health outcomes with less medical care spending. This money saved could be put to use on the leading determinants of health such as social welfare and personal health behavior programs.
Gen Z can use their technological knowledge to reduce medical costs as well. Online resources such as patient portals are more accessible and more often used by younger generations [6]. Using patient portals to seek medical information and records reduces the number of office visits and care that is provided by a physician. For example, if a patient has a sore throat, they can send a message to their provider through the portal, who can provide medical advice without the patient coming into the office. Telehealth patient visits are a similar cost-reducing trend that has exploded in popularity since the COVID-19 pandemic.
These goals are financially motivated because saving money in the healthcare system can help increase access [4]. As one of the most health-conscious generations in history, Gen Z must make it a priority to advocate for change in the financing of social programs to improve health and decrease healthcare expenditures. Doing this might just help this generation achieve their passionate goals of lowering drug prices, and increasing equity and access of healthcare.
References
Who is gen Z and how are they shaping the future of health benefits? Harvard Pilgrim Health Care - HaPi Guide. (2022, March 25). Retrieved October 28, 2022, from https://www.harvardpilgrim.org/hapiguide/the-zoomer-is-shaping-the-next-generation-of-health-benefits/
Artiga, S., Hinton, E. (2019, July 9). Beyond health care: The role of Social Determinants in promoting health and health equity. Kaiser Family Foundation. Retrieved October 28, 2022, from https://www.kff.org/racial-equity-and-health-policy/issue-brief/beyond-health-care-the-role-of-social-determinants-in-promoting-health-and-health-equity/
Choi, E., & Sonin, J. (n.d.). Determinants of health visualized. GoINVO. Retrieved November 11, 2022, from https://goinvo.com/vision/determinants-of-health/
Chang, T. (2022, June). Gen Z wants health providers to ask about food, housing, Safety & More. University of Michigan Institute for Healthcare Policy & Innovation. Retrieved October 28, 2022, from https://ihpi.umich.edu/news/gen-z-wants-health-providers-ask-about-food-housing-safety-more
Doran, T., Maurer, K. A., & Ryan, A. M. (2017). Impact of provider incentives on quality and value of health care. Annual Review of Public Health, 38(1), 449–465. https://doi.org/10.1146/annurev-publhealth-032315-021457
Alkire (née Nasr), L., O'Connor, G. E., Myrden, S., & Köcher, S. (2020). Patient experience in the digital age: An investigation into the effect of generational cohorts. Journal of Retailing and Consumer Services, 57, 102221. https://doi.org/10.1016/j.jretconser.2020.102221