There was an interesting story today in the Washington Post about how the economy is impacting consumer healthcare spending habits. The Rockefeller Foundation and Time Magazine partnered to explore this topic, and found an increase in the percentage of consumers who were holding off on treatment. This included delaying/cancelling important screenings such as mammograms and colonoscopies, delaying doctor visits for themselves and their children, postponing elective surgery, and taking less medication than prescribed. They also found more people turning to "home remedies." This behavior may have significant implications. On the communications front, it may make consumer healthcare Web sites even more important, as a free resource for consumers to turn to for medical advice, avoiding the costs of doctors. It could also open up opportunities for communication programs that emphasize compliance with important screenings, medications, etc. It certainly may impact the businesses of some of our important clients. Most disturbingly, it could lead to increased healthcare costs down the road, as consumers who delay treatment get sick or have their conditions deteriorate to the point that they need costly treatment that could have been prevented.

or......it might make people take a greater degree of personal responsibility to engage preventative methods such as eating differently, educating themselves as to how the body functions, and exercising to name a few. healthcare has had a tremendous emphasis on "professional management" which has encouraged people to rely on "fixing" or "continuously managing" conditions with pills and procedures rather than protect their greatest asset through prevention via healthy living.

What is interesting to us in healthcare - and I'd be interested to know what others are experiencing - is that despite the economic gloom-and-doom, we are seeing an uptick in new business leads. On the surface this might be somewhat surprising, as one might think that companies would be regrouping, watching and waiting to see where things go before committing to new resources and expenditures. On the other hand, it shouldn't be surprising, as smart companies know that they still have a business to run, and the smartest may recognize an opportunity to spend where competitors hesitate. It will be interesting to see in 3 or 6 months if the trend continues with businesses moving boldly forward or if the bad news begins to really alter how they do business.

I am struck by the seeming disconnect between the national dialogue around the economic crisis and what I see and hear in the suburbs. Yes, we hear the dramatic and devastating stories of families on the news, but at home are those same conversations occurring? Are the neighbors stuffing their mattresses with their 401ks? Or are we going on with our daily routines - buying groceries, Bakugan and fuel - just as we did a month ago. It seems as though the credit crisis is so large and looming that the average American is unsure of just what he or she can (or should) do. In the midst of the bailout discussions and new economic plans, have we missed an opportunity to push for individual behavior change? In Atlanta it took rising gas prices and a run on fuel to get people to start using enviromentally-friendly commute alternatives. As with any behavior change, the cost of living beyond our means has to outweigh the benefits of having it all before we're prompted to make a change. How can the credit crisis lead Americans to rethink their spending? In suburban Atlanta, at least, that change is still slow to come.

It's fascinating to compare this crisis with previous big shifts. Now commentators (thanks to Professor Nelson's research) are looking at the banking crisis of 1873 which was precipitated by a real estate bubble and created a five year recession. The big unknowable is the medium term effect of "nationalizing" what Lenin called the "commanding heights" of so many advanced economies. While the reforms are leavened with sunset provisions, power shifts of this magnitude have a way of creating their own inertia. Re-privatize the banks? Sure. When many European economies nationalized mining, transportation, utilities and other industries during WWII and after, it took 40 years, in some cases, to re-privatize. We'll see.