Not Afraid to Blame: The Neglected Role of Blame Attribution in Medical Consumerism and Some Implications for Health Policy

Posted: 22 May 2002

See all articles by Mark Schlesinger

Mark Schlesinger

Yale University - School of Medicine

Marsha Rosenthal

Rutgers, The State University of New Jersey - Institute for Health, Health Care Policy and Aging Research

Abstract

A crucial aspect of medical consumerism has been overlooked in past research and policymaking: how consumers decide whom to "blame" for bad outcomes. This study explores how, in a system increasingly dominated by managed care, these attributions affect consumers' attitudes and behavior. Using data from the experiences of people with serious mental illness, hypotheses are tested regarding the origins and consequences of blaming for medical consumerism. Blame was allocated to health plans in a manner similar, but not identical, to the way in which blame was allocated to health care professionals. Both allocations are shaped by enrollment in managed care, with blame allocation affecting consumers' subsequent willingness to talk about adverse events. Policy implications include the need for more finely tuned grievance procedures and better consumer education about managed care practices.

Suggested Citation

Schlesinger, Mark and Rosenthal, Marsha, Not Afraid to Blame: The Neglected Role of Blame Attribution in Medical Consumerism and Some Implications for Health Policy. Milbank Quarterly, Vol. 80, No. 1, March 2002. Available at SSRN: https://ssrn.com/abstract=304563

Mark Schlesinger (Contact Author)

Yale University - School of Medicine ( email )

Department of Epidemiology and Public Health
60 College Street, P.O. Box 208034
New Haven, CT 06520-8034
United States
203-785-4619 (Phone)
203-785-6287 (Fax)

Marsha Rosenthal

Rutgers, The State University of New Jersey - Institute for Health, Health Care Policy and Aging Research ( email )

30 College Avenue
New Brunswick, NJ 08901
United States
732-932-8638 (Phone)

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