In five years people will look back out how healthcare worked for patients in 2016, and they will wonder about two things:

• Why was it so archaic?
• What did it take so long to change?

There is a lot of talk about having care go from being hospital-centric to being patient-centric. There is also a lot of talk about people living on Mars, but nobody is counting on receiving emails from anyone on Mars very soon.

Everyone who has been a patient is in favor of a patient-centric care model. Many people would be happy to explain what a patient-centric care model should look like. Unfortunately, nobody with the ability to change the care model is listening.

One of the healthcare sectors that seems to be a couple of Freedom fires short of a Happy Meal when it comes to even making an effort to engage consumerism is the pharmaceutical industry. Did he just write that? Somebody has to say that the emperor is running around sans clothes. (If you don’t like what follows, you can run my blog through BeachBit.)

Big pharma. Big consumer problem; at least if big pharma is really interested in improving population health, accountable care, and star ratings.

Pharma looks busy, and they run a lot of ads. But running ads has nothing to do with consumerism even though consumers see those ads. They spend a lot on big data, and they probably learn enough from it to be able to say with a high degree of probability that some hypothetical person, based on a slew of factors (slew is not a medical term) is more likely than others to have a certain medical condition.

So, if you put a thousand hypothetical people in a room, and add the data that pharma has crunched, pharma may be able to state that 22.7% of those people are more likely to get, let’s say, heart disease than the other 77.3%. Do you know what they cannot say? They cannot point to you or me and say that you will get heart disease.

I used heart disease, because as many of you may recall, I have it. I do not write this to tell you about me, but to explain how an actual patient, me, looks at the healthcare consumerism role big pharma chooses not play. I had a heart attack in 2002. And every day since then I have taken six different medications to manage my heart disease.

I bet that almost every single patient dealing with some disease is in much the same boat as I am. I have no idea which pharmaceutical firm makes any of my six medications. I know the impact they have on me based on fourteen years of actual experience.

There is a side effect of one of my medications, Niaspan. The pages of 3-point text that come with my prescription states, it may cause flushing. That is the equivalent of saying that hurricane Katrina may cause rain. Flushing, for those of you who have never been flushed, is a polite way of saying that every inch of your body will feel like it is on fire.

So, when I look at what big pharma is doing about consumerism (insert population health, accountable care, patient-friendly) and compare it to what it could be doing, big pharma has to look up to just to see the bottom.

For further evidence, all you have to do is to look at any of their drug advertisements extolling you to talk to your doctor about using their drug. Pharma’s commercials remind me of the last few seconds of a car commercial, the part when the announcer speed reads the onerous terms of the car’s lease agreement. Pay no attention to the man behind the curtain.

Their ads are all the same; ten seconds of the Cleaver family having a picnic followed by twenty seconds warning you of the drug’s possible side effects overlaid with footage of Beaver and Wally playing badminton while June pulls pieces of perfectly fried chicken from the wicker picnic basket. The only thing missing from those ads is the same kind of warning from the Surgeon General that you see on a pack of cigarettes. “The most serious side effects may cause feelings of suicide.” (How’s that picnic look now? June, please pass the potato salad.)

Big pharma markets its drug to health systems—it will help your patients. It markets its drug to payers—you should cover the cost of this drug. It markets its drugs to the national pharmacy chains—you should carry this drug. It markets its drug to consumers—if you use our drug you can have a picnic.

In general, the only people managing their care are the people under care. Essentially, we are on our own. One you leave the hospital, they do not know how you are—unless, of course, you are readmitted. They payer does not know if the treatment for which they are paying was effective. The retail pharmacy does not even know if you are taking the drug they dispensed—over thirty percent of prescriptions are never picked up. And, big pharma does not even know that you exist—but they have a lot of data about hypothetical people like you.

Consumerism is on the threshold of working. The only thing it is missing is real consumers, you and me.

Big pharma could create a version of Facebook for the diseases their medications treat. They could design super-functional online, interactive, and cognitive health groups. They could employ social media, design thinking, and an aggregator of apps that collect, monitor, and assess patient data at an individual level to help patients manage their care and wellness.

They could. But, they aren’t.

If you think that healthcare is competitive now, tomorrow’s level of competition will make the Hunger Games look like a family outing or a Cleaver picnic.

Gone will be the phrase, “The doctor will see you now.”

It will be replaced by the phrase, “The patient will see you now.”

And when the patient does, wouldn’t both parties be served better if the patient had actually spent the time between their appointments doing all of the things they needed to do to manage their care? And wouldn’t be even better if big pharma or the provider or the payer or some national retail pharmacy chain was part of that process?