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Choice cuts: parsing policymakers’ pursuit of patient empowerment from an individual perspective

Published online by Cambridge University Press:  01 July 2010

Mark Schlesinger
Mark Schlesinger*
Affiliation:
Professor, Division of Health Policy and Administration, Yale School of Public Health, Yale University, New Haven, CT, USA
*
*Correspondence to: Professor Mark Schlesinger, Division of Health Policy and Administration, Yale School of Public Health, Yale University, 60 College Street, PO Box 208034, New Haven, CT 06520-8034, USA. Email: mark.schlesinger@yale.edu
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Abstract

In this commentary I explore several ways in which the psychology of individual decision-making shapes consumers’ choices in medical settings and the potential for choice-based policies to improve the performance of the health care system. This analysis draws some crucial distinctions among the various pathways though which policymakers expect choice to improve outcomes and the various forms of support that might enhance patients’ engagement with choice. I also consider how choice-promoting policies interact with other strategies for patient empowerment and depend crucially on the ways in which individual patients develop the capacity to make sense of their experiences with medical care. Drawing largely on data and studies from medical consumerism in the US, I identify a number of choice ‘pathologies’ that might compromise the influence or beneficial effects of choice-promoting initiatives. Though these limitations are unlikely to turn public officials away from their consumerist policy aspirations, identifying the realistic limitations of such initiatives makes clear the need to complement them with other strategies for enhancing patients’ well being and encouraging a more responsive health care system.

Type
Commentary
Information
Health Economics, Policy and Law , Volume 5 , Issue 3: Special Issue on Cross-Country Issues in Health Care: Choice, Equity, Efficiency and Cost , July 2010 , pp. 365 - 387
Copyright
Copyright © Cambridge University Press 2010

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