Whenever I talk about People-Powered Health(care) (PPH) I usually get asked how it is related to Consumer-Directed Healthcare (CDH).

CDH has been around for awhile. Over time the term acquired a well-defined meaning with strong political overtones. It divides industry pundits, politicians and various interest groups into different camps, largely on the basis of their preference of different care financing models.

If the main idea of CDH is "putting consumer in charge", what is there to add by this fancy newfangled "People Powered" label?

Well, a lot. How about ACTUALLY involving real consumers?

Wait a minute, you might say. CDH is supposed to be a good thing for consumers, it is there in the name, right? Well, in theory yes. BUT in practice have you ever seen a consumer involved in creation of a "consumer driven program"? How many people feel truly in control of their health and care?

There you have a problem.

I have yet to find a healthcare interest group not claiming to act in the best interests of the public. But how many are able to directly demonstrate real public support? Recent surveys indicate that real consumers are rejecting what is billed as "Consumer Driven" plans. Why is that? Are they dumb or what?

I do not buy into "cost-shifting conspiracy theories" propagated by advocates of government-run healthcare, but CDH movement as we know it is clearly not meeting real people's needs and running out of steam fast. What is the root cause?

Top-down approach to CDH design is to blame

A recurring theme in consumer-directed care discussions is about how to get "them" (the consumers) to change their ways. Buy certain products. Rethink life habits. Take financial responsibility (and risk) for their life and health decisions. The fatal flaw in many of these programs is that in the grand scheme of things  they view consumers as either revenue sources or cost centers by the healthcare industry and employers respectively. No wonder there is so much distrust.

People-Powered Healthcare is CDH turned upside down!

Look at my definition and you will see why. The main idea of PPH, in contrast with CDH, is "co-production of health services". PPH places the primacy with people just like you taking care of their health and well-being. Unlike traditional CDH approach, all about handing down "this is best for you" line.

Note the difference between "People", "Consumers" and "Patients". Consumer assumes someone ready to buy and consume something right away. You are not a consumer unless you are here to complete a transaction. Patient is what you are called when availed to the medical system. But most of the time we are neither consumers nor patients. We are people who want to live a healthy and fulfilling life. In business terms we could not care less who wants to sell to us and what.

Understanding this is key to surviving and thriving in PPH future

Make no mistake about it, People Powered Healthcare is coming armed with "technological, medical and political innovations", which I allude to in the definition. In the past, consumers did not have much direct recourse in voicing their likes and dislikes. But now the Internet and open media have already created a powerful influence mechanism. New healthcare delivery and payment models are emerging, often supported by technology. Online political action can really influence the legislative and executive rule-making process. There is nowhere to hide.

CDH movement is about to face Warren Buffet test: "When the tide goes down you find out who is swimming naked".

That means increased bottom-up scrutiny from those "consumers", whom CDH programs were supposed to benefit. Therefore expect to find the Consumer-Directed Healthcare camp fractured. Into those who learn to engage people grassroots action and those who fall behind and fail. If you are claiming to benefit "consumers", have you engaged real people and do they support you? If you are not asking this question your competition might. But remember that PPH credibility bar is higher and fake openness is uncovered fast.

Despite the populist sound PPH is a great entrepreneurial opportunity, and a viable alternative to government run healthcare

Think of a system based on freedom and choice and actually in line with the needs of the people. As I have written before in my "Michael Moore, Upton Sinclair and FDR"post such reforms have worked in the past. Whether private healthcare survives the pressure to reform will depend on ability of the industry leaders to engage real people. Embrace people power. Authentically. Right now.

Would be interesting to see who sinks and who swims