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The Challenge of Obtaining Quality Care: Limited Consumer Sovereignty in Human Services

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  • Kari Eika

Abstract

This paper offers a conceptual analysis of the problem of quality in human services: in elementary school, psychiatric care, and the health and social care of children, the elderly, and the intellectually disabled. Geriatric nursing home patients are used as a case. These care recipients cannot enforce their legal right to quality service; their quality-effective demand is low. Formal economic analyses often characterize the weak position of the care recipient as an information asymmetry problem. An additional obstacle, however, is the recipient's inability to safeguard her personal interest due to physical, mental, or social incapacities; that is, “limited consumer sovereignty.” Incapacitated individuals cannot enforce quality even when quality information is available. This creates a fundamental incentive problem in the monitoring of quality. They also depend on services that are complex and non-verifiable, making external monitoring difficult. This paper presents a typology of measures to increase the quality pressure facing providers.

Suggested Citation

  • Kari Eika, 2009. "The Challenge of Obtaining Quality Care: Limited Consumer Sovereignty in Human Services," Feminist Economics, Taylor & Francis Journals, vol. 15(1), pages 113-137.
    • Handle: RePEc:taf:femeco:v:15:y:2009:i:1:p:113-137
    DOI: 10.1080/13545700802446658
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    References listed on IDEAS

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    1. Jean Tirole, 1988. "The Theory of Industrial Organization," MIT Press Books, The MIT Press, edition 1, volume 1, number 0262200716, April.
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    Cited by:

    1. Janina Cizikiene & Audrone Urmanaviciene, 2018. "The Aspects Of Provision Of Social Services Considering The Social Exclusion Dimensions In The Context Of Rational Choice Theory," Eurasian Journal of Social Sciences, Eurasian Publications, vol. 6(1), pages 29-36.

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    More about this item

    Keywords

    Consumer sovereignty; care quality; human services; impaired consumers; quality-effective demand; public supervision; JEL Codes: I1; I11; I18;
    All these keywords.

    JEL classification:

    • I1 - Health, Education, and Welfare - - Health
    • I11 - Health, Education, and Welfare - - Health - - - Analysis of Health Care Markets
    • I18 - Health, Education, and Welfare - - Health - - - Government Policy; Regulation; Public Health

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