Fri 4th June - Patient Choice: Are We Ready to Bleed?

This week, Sebastian will introduce the topic: “Patient Choice – Are We Ready to Bleed?”

Recent reforms of health care systems in several countries have emphasised “patient choice” as a means to increase efficiency through competition and implemented aspects of it (e. g. Blair’s reform of the NHS in the UK, but in this respect very similar ones took place in Germany and Sweden) with mixed results (see background). At the same time, in some countries an individual may even choose not to buy (specific) health insurance at all, an option which is currently much debated in the context of the US health care reform.

The issue of patient choice can be looked at from many perspectives. Among others, suggested questions are for instance: why limit patient choice in the first place, or, what is the rationale for paternalism in medicine? What are the conditions on information availability and communicability for effective patient autonomy, and do technological advancements strengthen or weaken the case for patient choice? How much choice and responsibility (and liability) do individuals actually want to have?

Some background links:

• Summary of (and link to) a recent study of the effect of patient choice on the UK’s NHS

• TED talk by Barry Schwartz on what may be termed “choice overload”

• An article by George Loewenstein and two MDs arguing for “asymmetric paternalism” on the basis of findings in behavioural economics

• Rothschild and Stiglitz wrote a classic article on competition and insurance

As usual, we meet today in STICERD social space at 6pm sharp.