The following opinion piece appeared in Sunday, Oct. 18, 2009 edition of the Houston Chronicle in the Outlook section.

Betsy Gelb, Larry J. Sachnowitz Professor of Marketing at UH Bauer College

Journals that focus on academic research in marketing are teeming with ideas that might inform the current debate in Washington on buying and selling health care. As co-directors of the Institute for Health Care Marketing in the Bauer College of Business at the University of Houston, we wish more ideas from such research gained consideration. Here are a few examples:

Business decisions today are international; firms will move their operations to cut costs. At a focus group of Houston benefits managers, one participant burst into tears, having been told by her firm’s CEO that unless she brought down health care costs “you’ll be responsible for our moving overseas and destroying 1,400 jobs here, including yours.” Our conclusion: The U.S. doesn’t have the luxury of maintaining the buying and selling of health care at current cost levels.

Partha Krishnamurthy, Associate Professor, Bauer Faculty Fellow and Director of Institute for Healthcare Marketing, UH Bauer College

However, international thinking has an upside. Through a variety of mechanisms, university-based medical centers typically receive higher payments than other hospitals, helping them to pursue vital research. The reputation they earn with those activities attracts top-dollar-paying international patients to many U.S. institutions. Our conclusion: Reducing payments to academic medical centers will not only harm them, but adversely affect the flow of self-paying international patients to all American hospitals. Adequate payments from Medicare and other government programs are not simply costs. They are actually investments.

Many expenditures by consumers and businesses involve purchasing what are called “unsought goods.” If a building floods, you pay to clean the carpets. But this is not an expenditure you make voluntarily or enthusiastically, even if you can well afford it. Health insurance is an “unsought good” for many — viewed as not needed because the average person thinks that he/she is luckier than the average, based on what researchers call the “self-positivity-bias.” Our conclusion: If policymakers want insurers to cover all who may need health care, the requirement of insurance purchase by all, with subsidies as necessary, must be legislated. Our current system of employer-provided health insurance masks the fact that many individuals would wait until an illness or injury strikes to buy insurance if coverage at that point were guaranteed.

We offer these examples to make the point that thinking like a marketer can be useful in the current policy-forming process. After all, the primary issues concern not health care itself, but the system through which it is purchased: The domain of marketing. Assumptions about what companies or individuals will do if a policy is framed in a particular way can be crucial. We believe that consideration of research in the field of marketing can help.

Gelb is the Larry J. Sachnowitz Professor of Marketing and Entrepreneurship in the Bauer College of Business at the University of Houston. Krishnamurthy is an associate professor at Bauer.