When Patients Say No (To Save Money)

An Essay on the Tectonics of Health Law

This legal analysis evaluates whether consumerism and mandated disclosure of information can provide a viable mechanism to improve health care quality and lower costs. The authors first determine the prerequisites for a functional consumerist health care system and then assess whether these prerequisites can be met based on empirical evidence.

Key Findings:

  • Prerequisites for a functional consumerist health system are numerous and complex. Consumers must have choices on their coverage, health care provider and care. Reliable data must be provided by doctors and received by patients who must be able to understand and act upon the information.
  • Empirical evidence suggests that there are serious barriers to meeting each prerequisite and that the prerequisites cannot all be met on a reliable basis.

The process of creating a consumer-driven health care system faces daunting challenges. While consumerist tools may have value in the health care system, they must be used cautiously and with the expectation of significant challenges.

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