Issues of cost and quality: barriers to an informed debate
Caryl E. Carpenter PhD,
John M. Cornman, A. Douglas Bender PhD,
David B. Nash MD MBA,
Corresponding Author
Caryl E. Carpenter PhD
Associate Professor, Widener University, Chester, PA, USA
Health & Medical Services Administration Widener University 1 University Race Chester PA 19013 USASearch for more papers by this authorA. Douglas Bender PhD
Associate Professor, Widener University, Chester, PA, USA
Search for more papers by this authorDavid B. Nash MD MBA
Associate Dean, Office of Health Policy and Clinical Outcomes, Thomas Jefferson University, Philadelphia, PA, USA
Search for more papers by this authorCaryl E. Carpenter PhD,
John M. Cornman, A. Douglas Bender PhD,
David B. Nash MD MBA,
Corresponding Author
Caryl E. Carpenter PhD
Associate Professor, Widener University, Chester, PA, USA
Health & Medical Services Administration Widener University 1 University Race Chester PA 19013 USASearch for more papers by this authorA. Douglas Bender PhD
Associate Professor, Widener University, Chester, PA, USA
Search for more papers by this authorDavid B. Nash MD MBA
Associate Dean, Office of Health Policy and Clinical Outcomes, Thomas Jefferson University, Philadelphia, PA, USA
Search for more papers by this authorFirst published: 29 July 2010
Abstract
Debates over health reform in the United States are hampered by a poorly informed public and misunderstandings about the concepts of quality, cost containment and their relationship to each other. This paper explores the nature and persistence of barriers to an informed public discussion of reform proposals. Those barriers are: (1) multiple definitions of quality, cost and cost containment, (2) the impact of the media on those definitions, (3) a false assumption that cost containment automatically results in diminished quality, and (4) the perceived impact of managed care and for-profit health firms on that assumption. We suggest a framework for building the understanding and knowledge base necessary to a reform of the nation's health care system.
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