Personal accountability has been a divisive issue in health care, with positions revealing an ideological chasm between those who see health care as a privilege and those who see it as a right. The discussion is generally limited to accountability for payment regarding whether the health care system should expect individuals to take prudent action to protect themselves from future health care costs, usually by buying insurance. While certainly an important issue, this framing ignores deeper questions that have left accountability only superficially examined in the health care system. Value-based care encourages more accountability for clinicians and health care organizations to achieve better outcomes. It is time to examine the role of the patient in determining these same outcomes so that accountability is appropriately assigned and incented.
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Johnston SC. The Risk and Cost of Limited Clinician and Patient Accountability in Health Care. JAMA. 2019;322(18):1759–1760. doi:10.1001/jama.2019.14832
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