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# On “consumership” in healthcare
- URL: https://www.chudgar.com/on-consumership-in-healthcare/
- Published: 2018-05-25T05:00:00.000Z
- Updated: 2023-08-10T21:24:10.000Z
- Description: The healthcare system tells people they should be good “healthcare consumers,” and they believe it. This delusion is heartbreaking. In reality, there is no such thing as a “heath care consumer.” There are only people with bodies, who love other people with bodies.
- Author: Ash Chudgar
- Tags: Consulting, Longreads, Healthcare, Writing, Personhood, Embodiment

### “My main point was to keep my kid alive.”

So says the father of a six-year-old girl with cancer in [Vikki Ortiz’s gut-punch of a story in the *Chicago Tribune*](http://www.chicagotribune.com/lifestyles/ct-life-debt-from-cancer-20180520-story.html?ref=chudgar.com) about “cancer-related financial toxicity.”

Here’s what I learned from that story:

It is long past time to abandon the delusion that [the “market” for health care can or should operate like a market for any other consumer good](https://www.forbes.com/sites/johngoodman/2018/05/22/can-the-market-really-work-in-health-care?ref=chudgar.com).

It’s long past time to let go of the delusion that we can fix things by inventing new and better “market driven reforms that,” as [the CMS writes brightly](https://innovation.cms.gov/initiatives/direction/?ref=chudgar.com), “empower beneficiaries as consumers.”

The cherished fantasy of a “market” in which “health care consumers” make rational economic choices: that woefully common fetish generates more than wildly incoherent (and [grotesquely profitable](https://www.economist.com/business/2018/03/15/which-firms-profit-most-from-americas-health-care-system?ref=chudgar.com)) health policy — though it certainly generates plenty of that.

Here’s the kicker: We tell people they *should* be good “health care consumers,” and they believe it.

They believe it so deeply that, when getting care for a serious illness bankrupts them, they’re *ashamed*. They think they’ve failed.

To get that shame out of the shadows, we’ve name it like a disease. Per the *Tribune:* advocates like [Carla Tardif](https://twitter.com/familyreachceo?lang=en&ref=chudgar.com) of [Family Reach](https://familyreach.org/?ref=chudgar.com) “say they hope to take the shame out of cancer-related financial toxicity.”

The shame of [#CRFT](https://threadreaderapp.com/hashtag/CRFT?ref=chudgar.com): the shame of not having “shopped” well enough; the shame of needing care in the first place; the shame of not being rich; the shame of being a bad “health care consumer.” This delusion is heartbreaking.

So, please, let’s agree on one clear and simple truth:

## **There is no such thing as a “heath care consumer.”**

There are only people with bodies, who love other people with bodies, and who respond to the threat of suffering or death with a sincere willingness to go to any length, incur any debt, and suffer any indignity.

In short, [#consumership](https://threadreaderapp.com/hashtag/consumership?ref=chudgar.com) in health care is a sick joke. Let’s stop telling it.