INTRODUCTION

Never before have the pressures and opportunities been greater for patients to get smart about their healthcare decisions.

According to data from the Commonwealth Fund in 2007 more than 50 million adults in the United States are uninsured, and another 25 million have inadequate medical insurance. More than one half of the underinsured and about two thirds of the uninsured went without needed medical care and approximately 50% had difficulty paying their bills. In fact, half of all bankruptcies in the United States are related to the difficulty of paying healthcare bills. Now, we are also in the midst of the worst economic downturn since the Great Depression, with rising unemployment further threatening insurance coverage. And even if one is fortunate enough to maintain coverage, benefits have been constricting due to rising cost pressures.
In healthcare, flattening is occurring in two major arenas to empower patients to more fully participate in their healthcare decisions and broaden the horizons within which they can implement them.