Journal
JOURNAL OF HEALTH AND SOCIAL BEHAVIOR
Volume 51, Issue -, Pages S147-S159Publisher
SAGE PUBLICATIONS INC
DOI: 10.1177/0022146510383497
Keywords
trust; illness behavior; reimbursement; physician organization; medical care utilization; managed care
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Health reform efforts in the United States have focused on resolving some of the fundamental irrationalities of the system whereby costs and services utilization are often not linked to improved patient outcomes. Sociologists have contributed to these efforts by documenting the extent of problems and by confronting central questions around issues of accountability, reimbursement, and rationing that must be addressed in order to achieve meaningful reform that controls costs, expands access, and improves quality. Major reform rarely occurs without paying off powerful interests, a particularly difficult challenge in the context of a large and growing deficit. Central to achieving increased coverage and access, high quality, and cost control is change in reimbursement arrangements, increased accountability for both costs and outcomes, and criteria for rationing based on the evidence and accepted as legitimate by all stakeholders. Consensus about health reform requires trust. The traditional trust patients have in physicians provides an important base on which to build.
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