Empowering Consumers Will Make Value-Based Programs Work

Berger equated progress in health plan reform to environmental changes in the country—slow going, but an inexorable force.

"Years ago, people would throw garbage out the window and littering was a terrible problem in this country. Then it became a point you were embarrassed if you threw something out the window. Society as a whole rewarded those who didn't. It created a stigma for those who did."

Indeed, in 1965, the government realized that garbage had become a major problem and Congress passed the Solid Waste Disposal Act, which called for the nation to find better ways of dealing with trash. By 1986, Rhode Island passed the first mandatory recycling law.

Progress. Like any of these movements, whether anti-garbage campaigns, or even the cultural war against smoking, the move to get more consumers involved in their own healthcare can certainly happen, but it is tenuous and takes a long time. In healthcare, we're really relying mostly on patients themselves, ensuring they take those moments to exercise, and don't cut their pills in half—to save a few bucks, a move that may haunt them later on.