Consumers of human services: powerless or poorly informed?
Consumer choice in social care may worsen quality at the low end of the quality scale. Many social care recipients are not consumer sovereign; they depend on others to safeguard their interests, but their representation may be weak. U.S. and Norwegian data on nursing home patients‘ complaint behaviour and family network substantiate this claim. A Schelling diagram shows how residents‘ dependency – when only some individuals have representatives who search for good homes and monitor care – increases (decreases) the proportion of residents with committed representatives monitoring care in high (low) quality homes. Though choice is important as an individual right, public supervision is necessary to protect vulnerable consumers.
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