Consumer competence and the reform of American health care
S. J. Reiser
Program on Humanities and Technology in Health Care, The University of Texas Health Science Center, Houston 77225.
This report examines the role of the expert in the American health care
system, both as provider and administrative policymaker. It shows that the
guiding assumption of American health care policy, ie, that the medical
system can and should be managed by experts on behalf of consumers and
patients, does not hold up to scrutiny. It also demonstrates that the
important theme in American history of placing authority and responsibility
for action in the hands of the individual has not been sufficiently
influential in American health care. Drawing on this theme and creating
consumer competence and responsibility in health care choices as the keys
to health care reform in the United States are advocated.
