title: Not afraid to blame: the neglected role of blame attribution in medical consumerism and some implications for health policy.
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.
authors.affiliation: Rutgers University, USA.
authors.forename: Marsha
authors.initials: M
authors.lastname: Rosenthal
authors.forename: Mark
authors.initials: M
authors.lastname: Schlesinger
mesh_terms: D001294:Attitude to Health; D003254:Consumer Advocacy; D003258:Consumer Behavior; D003695:Delivery of Health Care / Q000639:trends; D015438:Health Behavior; D019538:Health Care Surveys; D006291:Health Policy; D006302:Health Services Research; D006801:Humans; D008318:Malpractice; D008329:Managed Care Programs / Q000458:organization & administration*; D008402:Mass Media; D011593:Psychology, Social; D012539:Scapegoating; D012941:Social Responsibility; D014481:United States