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Book and Media Reviews
September 19, 2007

Health Care at Risk: A Critique of the Consumer-Driven Movement

Author Affiliations

Book and Media Reviews Section Editor: John L. Zeller, MD, PhD, Contributing Editor.

JAMA. 2007;298(11):1334-1340. doi:10.1001/jama.298.11.1336

As the 2008 presidential election approaches, health care reform is again part of the national conversation. One of the most compelling voices is Harvard Business School professor Regina Herzlinger, whose book, Market Driven Health Care, makes the case for free market competition, consumer choice, and innovative management. Herzlinger is just one of an articulate group of mostly conservative academics and pundits who advocate consumer-driven health care (CDHC), a health policy framework emphasizing enhanced consumer access to information, greater engagement in medical care decisions, and more responsibility for sharing in the costs of care. With more skin in the game, the theory goes, health care consumers will seek lower cost, better quality, and higher-value care. Most importantly, they will steer clear of moral hazard, purchasing only the health care they need—or, more precisely, only the health care that enhances their welfare more than alternative goods such as food, transportation, or movie tickets.