Open AccessExpectations of health care: promoted, managed or shared? [Note 1. Based on a lecture to the United States Society ...]
Author(s) -
Hart Julian Tudor
Publication year - 1998
Publication title -
health expectations
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.314
H-Index - 74
eISSN - 1369-7625
pISSN - 1369-6513
DOI - 10.1046/j.1369-6513.1998.00001.x
Subject(s) - trustworthiness , control (management) , value (mathematics) , business , managed care , health care , nursing , cost control , public relations , marketing , psychology , medicine , finance , economics , social psychology , political science , management , machine learning , computer science , economic growth
Volume, costs and content of medical care depend on professional and public expectations. The UK National Health Service (NHS) removed price barriers to access, so depressed expectations became an important factor in cost control. In USA, professional control of care business inflated expectations and costs. Managed care in the NHS failed to rationalize care because managers seem even less trustworthy than clinicians as arbiters of rational expectations in contexts of underfunding. Rational expectations depend on restored trust, mutual and managerial respect for expertise of both clinicians and patients, and transcendence of the provider‐consumer model for value production in medical care.