Tailor-made finance versus tailor-made care. Can the state strengthen consumer choice in healthcare by reforming the financial structure of long-term care?

Journal of Medical Ethics
K Grit, A de Bont

Abstract

Policy instruments based on the working of markets have been introduced to empower consumers of healthcare. However, it is still not easy to become a critical consumer of healthcare. The aim of this study is to analyse the possibilities of the state to strengthen the position of patients with the aid of a new financial regime, such as personal health budgets. Data were collected through in-depth interviews with executives, managers, professionals and client representatives of six long-term care institutions. With the introduction of individual budgets the responsibility for budgetary control has shifted from the organisational level to the individual level in the caregiver-client relationship. Having more luxurious care on offer necessitates a stronger demarcation of regular care because organisations cannot simultaneously offer extra care as part of the standard care package. New financial instruments have an impact on the culture of receiving and giving care. Distributive justice takes on new meaning with the introduction of financial market mechanisms in healthcare; the distributing principle of 'need' is transformed into the principle of 'economic demand'. Financial instruments not only act as a countervailing power against...Continue Reading

Citations

Oct 4, 2011·Journal of Medical Internet Research·Grazia OrizioUmberto Gelatti
Dec 12, 2013·Health Care Analysis : HCA : Journal of Health Philosophy and Policy·Lieke OldenhofKim Putters
May 9, 2015·Health Care Analysis : HCA : Journal of Health Philosophy and Policy·Kor Grit, Teun Zuiderent-Jerak
Aug 24, 2017·Scandinavian Journal of Caring Sciences·Åshild SlettebøAnne Skisland

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