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A crucial aspect of medical consumerism has been overlooked in past research and policymaking: how consumers decide whom to “blame” for bad outcomes. This study explores how, in a system increasingly dominated by managed care, these attributions affect consumers’ attitudes and behavior. Using data from the experiences of people with serious mental illness, hypotheses are tested regarding the origins and consequences of blaming for medical consumerism, Blame was allocated to health plans in a manner similar, but not identical, to the way in which blame was allocated to health care professionals. Both allocations are shaped by enrollment in managed care, with blame allocation affecting consumers’ subsequent willingness to talk about adverse events. Policy implications include the need for more finely tuned grievance procedures and better consumer education about managed care practices.
Author(s): Marsha Rosenthal; Mark Schlesinger
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Volume 80, Issue 1 (pages 41–95) DOI: 10.1111/1468-0009.00003 Published in 2002
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The Milbank Quarterly’s multidisciplinary approach and commitment to applying the best empirical research to practical policymaking offers in-depth assessments of the social, economic, historical, legal, and ethical dimensions of health and health care policy.