Patients or Customers: Ethical Limits of Market Economy in Health Care

Heubel, Friedrich

doi:10.1076/0360-5310(200004)25:2;1-o;ft240

Cited by 13 publications

(8 citation statements)

References 3 publications

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“…Patients without medical insurance showed lower responsibility, which is probably related to the materialistic nature of the patient–provider relationship. These patients may treat the patient–provider relationship as a buyer–seller relationship [43–44]; correspondingly, they may consider that the extent of their responsibility to the provider is to pay the fee.…”

Section: Discussionmentioning

confidence: 99%

Patients’ sense of responsibility to healthcare providers and its predictors: A national cross-sectional survey in China

Wang²,

Wang

et al. 2018

PLoS ONE

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ObjectivesTo evaluate patients’ sense of responsibility to healthcare providers and to determine its predictors using on a national sample in China.MethodsWe conducted a national cross-sectional survey in China with a stratified cluster sample of patients treated in 77 hospitals between July 2014 and April 2015. Patients’ sense of responsibility to healthcare providers was measured with four questions assessing patients’ perceptions regarding their responsibilities to respect doctors, respect nurses, coordinate with health professionals, and comply with hospital rules. Predictors included patient sociodemographic characteristics and their past hospitalization experience.ResultsSmall proportions of respondents reported that they perceived having no responsibility to respect doctors (8.9%), respect nurses (7.9%), comply with hospital rules (6.7%), or coordinate with health professionals (6.3%). Multivariate regression analyses showed that the strongest predictor of patients’ sense of responsibility to healthcare providers was patinets’ trust in health professionals, followed by patients’ education level. Familiarity with healthcare professionals and past hospitalization frequency were inversely associated with patients’ sense of responsibility to healthcare providers.ConclusionsAlthough only a small proportion of the patients reported feeling no or low sense of responsibility to healthcare providers, the lack of respect and collaboration from these patients can negatively affect patient-provider relationships. Healthcare administrators need to communicate clearly with the patients and the public about the role of patients and the limitations of medicine in order to instill a sense of patients’ responsibility.

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Section: Discussionmentioning

confidence: 99%

Patients’ sense of responsibility to healthcare providers and its predictors: A national cross-sectional survey in China

Wang²,

Wang

et al. 2018

PLoS ONE

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“…For many, health care provision is a moral issue and private provision -implying as it does that profits should be made from the health needs of others -is argued to be morally inferior to public provision (see, for example, Heubel, 2000;Le Grand, 2001;Matthews, 1998). This argument may be of intellectual interest, but it is a complete non sequitur when in reality the choice is between two systems of health care provision, one of which offers a level of efficiency that the other cannot match and therefore provides a higher standard of care at the same cost.…”

Section: The Socialist Calculation Debatementioning

confidence: 98%

The British National Health Service: Lessons from the ?Socialist Calculation Debate?

Meadowcroft

2003

The Journal of Medicine and Philosophy

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The "Socialist Calculation Debate" is little known outside the economics profession, yet this inter-war debate between liberal and socialist economists on the practical feasibility of socialism has important implications for all contemporary public sector bureaucracies. This article applies the Mises-Hayek critique of central planning that emerged from this debate to the crisis presently facing the British National Health Service. The Mises-Hayek critique suggests that the UK government's plan for a renewal of the National Health Service will fail because of the epistemological pathologies that face any centrally planned system. It is argued that the key lesson of the Socialist Calculation Debate is that market prices and private property rights are essential for the efficient allocation of resources and the attainment of the best possible health outcomes.

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“…Such free-rider considerations may explain a great deal of the predominant attitude toward insurance in Germany and The Netherlands (Heubel, 2000;Kirkman-Liff, 1991). All non-indigent, low and middle income citizens are expected to insure themselves.…”

Section: Free-riding and Compulsory Universal Insurancementioning

confidence: 98%

How Compatible Are Liberty and Equality in Structuring a Health Care System?

Menzel

2003

The Journal of Medicine and Philosophy

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In their normative role in shaping the basic structure of a health care system, liberty and equality are often thought to conflict so sharply that health policy is condemned to remain an ideological battleground. In this paper, I will articulate my own view of why much of the apparently fundamental conflict between individual liberty and responsibility, on the one hand, and equality and equality's related concern for cost-efficiency, on the other hand, is less intractable than it is usually assumed to be. The result will be to break the rigid and stereotypical association of liberty-emphasizing social philosophies with the pluralistic market paradigm for a health care system and egalitarian, equity-emphasizing social philosophies with the unitary public system paradigm. Understanding better the moral ingredients of liberty and equitable distribution as well as the complexity of how liberty and equality actually intersect in a health care system opens the door to seeing the possibility of significant reconciliation. I will conclude, among other things, that even semi-libertarian views of distributive justice should strongly embrace compulsory, universal coverage of health care for some significant level of care, and that egalitarian views ought not to regard different levels of coverage for people of different income levels as necessarily unjust.

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Patients or Customers: Ethical Limits of Market Economy in Health Care

Cited by 13 publications

References 3 publications

Patients’ sense of responsibility to healthcare providers and its predictors: A national cross-sectional survey in China

Patients’ sense of responsibility to healthcare providers and its predictors: A national cross-sectional survey in China

The British National Health Service: Lessons from the ?Socialist Calculation Debate?

How Compatible Are Liberty and Equality in Structuring a Health Care System?

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