When we talk about health consumerism or the consumerization of health, the topic encompasses a lot of disparate ideas. In her new book Health Consuming: From Health Consumer to Health Citizen, Jane Sarasohn-Kahn, a health economist with a 30-year background in the space, seeks to tie those ideas into one cohesive narrative — and to follow that narrative to see where it leads into our future.

The first idea is simply that patients are increasingly becoming consumers because they have an increasing responsibility for the cost of their care.

“The reality is the patient is forced to be a consumer with high deductibles, with co-insurance,” Sarasohn-Kahn told MobiHealthNews. “I’m not saying it’s a good thing; I’m saying that’s the reality. So the first point there: The patient is the payer is the consumer.”

Consumers, Sarasohn-Kahn said, are looking for two things as they make their spending choices: value (getting the most for their money) and values (what’s meaningful and important to them). That connects to the next idea, the idea of digital health tools changing the healthcare experience.

“As a consumer, I am 'Amazon Primed' now,” Sarasohn-Kahn said. “I am expecting service and value. Then you get to the third point: how do I do that? I do that in my community, I do that with retail health touchpoints … and we can do that through the cloud and digital platforms. There’s a whole chapter on digital enabling the patient in the community to help manage costs and assess quality preferences.”

That leads into the fourth idea, which is that increasing use of digital tools in healthcare is creating new and unprecedented amounts of data that our current systems aren’t well-equipped to handle.

So where does citizenship fit in? Well, in the US in particular Sarasohn-Kahn posits that there are problems that can’t be solved by individuals or by the industry, but have to be solved by government-level policy changes.

“Even though we spend way more in the US than any other country on healthcare, we have worse outcomes in terms of life expectancy,” Sarasohn-Kahn said. “And so the argument then is to bake health into other policies in government. That’s what the last chapter is about.”

And that doesn’t just apply to healthcare policy, although it’s critical that the government take action on things like skyrocketing drug prices. But as Sarasohn-Kahn notes in the book, data also seems to support a link between health outcomes and social spending.

“The US spends about equally social and healthcare, but France spends 2.7 times more on social than healthcare, Sweden 2.5 times, Norway 2.4 times, and their life expectancies are much greater,” she said.

Sarasohn-Kahn uses the term “citizen” specifically because citizens have responsibilities as well as rights. And for health citizens, their responsibility is to do everything they can do to manage their own health — something with which digital tools and social programs can help.

“My goal was to connect the dots between these disparate areas to tell the story about why people are health consumers and why it’s important for us to start to move toward this concept of health citizenship, with rights and responsibilities for people underpinned by digital health and better privacy law,” Sarasohn-Kahn said.

Sarasohn-Kahn is diving deep into these ideas on her own blog, Health Populi, in a multi-part series.