Consumer sovereignty in health care holds only when consumers have the powers to dictate what is produced in the health care system. This is not the case even in the industrialized or developed economies because the per capita health care expenditure in the United States are by far the highest (Sirgy, 2011). Statistics indicated that health care expenditures continue to grow geometrically, which is a suggestion that consumer sovereignty in health care is fiction. Analysis showed that health care system mostly uses consumer-based directed care, which was initially libertarian/market-based model. This model continues to increase disparity between the haves’ and have nots’.
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Generally, consumer exercise their sovereignty in the marketplace to ensure the availability and adequacy of services. However, the applicability of sovereignty model in medical services market is marginally successful even in a sophisticated economy. One of the major reasons relates to the economic concept of need versus demand and the consequences of the consumer’s uncertainty about medical service product (Christensen & Wertheimer, 1976). Even the most knowledgeable and sophisticated consumers, they are hardly experts to evaluate the medical service or determine the best care to their needs. The prerogative of the medical practitioner predominate patients needs and desires.
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The other reason sovereignty model in health care has failed is the challenges encountered by patients in attaining access to the medical care market due to ethnocultural, economic and geographical barriers. The third reason is the nature of illness which significantly reduces the power of the consumer to exercise his right of refusal or to choose the medical market (Sirgy, 2011). Some conditions require emergency services, which makes it impossible to seek alternative medical service elsewhere impossible. In all these situations, the agent involve is the physician because they decide the best treatment available for the patient. The pharmacists will be there to dispense the prescription of drugs. Sometime insurers may influence the decision of the physician by setting the rate of reimbursement based on the price of drugs prescribed.
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