Nutrition and Health Sciences, Department of


Date of this Version



Published in Consumer Behavior in the Health Marketplace: A Symposium Proceedings, Ian M. Newman, Editor, Nebraska Center for Health Education & University of Nebraska-Lincoln, 1976.


The particular aspect of "consumer behavior in the health marketplace" I should like to emphasize is the problem of access to medical care.

Health care policy makers, planners, administrators, and medical care consumers themselves are increasingly voicing their concern that access to the medical care system should be improved. A plethora of programs has been launched during the past decade with the expressed objective of achieving equity of access to medical care in the United States.

Some of these programs are directed at increasing the buying power or medical knowledge of the health care consumer-e.g., Medicaid, Medicare, national health insurance, and health education and nutrition programs. Others seek to improve the availability or organization of medical manpower and facilities-e.g., development of family practice as a specialty, paramedical training programs, and HMOs.

All these programs are intended in some way to provide equal access to the medical care system to various groups in the population. Just what the concept of "access" means, however, much less how it might be measured and what methods should be used to evaluate it, is ill-defined. Thus far, access has been primarily a political concept. It has for some time been an expressed or, at least, implicit goal of health policy, but few attempts have been made to provide systematic conceptual or empirical definitions of access that would permit policy makers and consumers actually to monitor the effectiveness of various programs in providing equal access to the medical system.