patient - consumer - customer - care giver

I have long advocated for a change in the role of patients to that of care-giver and as much as I appreciate some of the insights of the recent epatient movement and the consumer health movement both sill fails to reposition the person receiving the care as the primary person providing the care as well. We aren't just patients - but caregivers as well. We are also the only people in the healthcare system who don't actually make a living from it.

Deloitte recently produced a great report - 2012 US Survey of Health Care Consumers comparing patients to consumers (first two columns) and I suggest that the next stage will be a shift from consumer to Care-giver. (last columns). Feel free to give feedback as this is the 1st draft.

	Patients	Consumers	Care-Giver
Level of engagement  in decisions about  their treatments	Low level of engagement, depend upon physicians to make decisions on their behalf	High level of engagement, depend on physician recommendation augmented by own research to confirm or corroborate	System is designed around patients needs, values and workflows embeds patient in the care team decision making process and information flows.
Level of awareness  of treatment options and associated costs	Low level of awareness, depend on physician opinion	High level of awareness, depend on information sources from online tools and social media	Value and personal values become key metric in decision making and entire  care team including providers are  aware of options and costs.
Source of trust in  providers they use	High level of trust, based on personal experiences and word-of-mouth	High level of trust, based on personal experiences and comparison shopping	High level of trust in systems of care and subject matter experts as a result of increased access to patients own health care information.
Primary unmet needs	Unmet needs resolved through access to care system within a reasonable timeframe + personal attention	Unmet needs resolved through value-based strategies combining access + service delivery + outcomes + cost	Unmet needs meet through customized treatment that considers patients values and choices as well as outcomes and cost
Unmet need from  insurance plan sponsor	Unmet need strategies adopted by insurance plans based upon large networks of providers to enhance access and convenience + manageable out-of-pocket costs	Unmet need strategies adopted by insurance plans based upon narrow networks of high-performing (high-value) providers + predictable costs	Unmet needs shift from insurance based cost sharing to  value brokers and new delivery systems that advocate for patients and care givers.

Any thoughts?