Healthcare satisfaction guaranteed

La veu de la ciutadania: Com la percepció de la ciutadania es vincula a la millora dels serveis sanitaris i el sistema de salut de Catalunya

In Exit, Voice, and Loyalty (1970), the book written by Albert O. Hirschman, you finally understand that the ultimatum that confronts consumers in the face of deteriorating quality of goods is either “exit” or “voice”. Exit is equivalent to the invisible hand of markets in Adam Smith. The greater the availability of exit, the less likely voice will be used. However, loyalty may modulate the final impact. Loyal members become especially devoted to the organization's success when their voice will be heard and that they can reform it.
Under mandatory publicly funded health insurance, the role of voice is specially relevant to fulfill citizens expectations. The efforts to measure patient satisfaction provide precise information on this issue. Now you can find an excellent report that summarises recent trends under a strict methodology.
The results (from p.65) are clear: currently the levels of satisfaction with public health services are higher than at the begining of the crisis. I have already posted about the same before, however what you'll find today as headlines in the newspapers is exactly the opposite. Journalism ethics is not currently in its best days. As citizens we deserve better consideration.
Fortunately, internet allows to bypass journalists ("exit" in Hirshman words), though it requires a dose of extra effort and only a minor part of the population is prone to assume it.
If healthcare satisfaction is rising, as it is, then no need for exit, citizens will remain loyal.

PS. In case of severe disease, voluntary health insured members would use private services in 32% of cases, while public sevices in 39% of cases. P.9 of the barometer.

PS. Journalism ethics: Seek Truth and Report It

Exit, voice and loyalty

Toca rellegir Hirshman aquests dies. Han passat més de 40 anys però encara hi ha molt per aprendre d'allò que ell proposava a "Exit, Voice and Loyalty". Quan la sortida no és possible, aleshores només cal escoltar la veu. Diu:

The voice option is the only way in which dissatisfied customers or members can react whenever the exit option is unavailable. This is very nearly the situation in such basic social organizations as the family, tIle state, or the church

Ara bé, em poso a pensar un moment i en el fons potser convindria trobar espais on la "sortida", en termes de Hirschman, fos possible dins els sistemes d'assegurança sanitària universal. Un situació per exemple és afavorir la capacitat d'elecció de centre i de metge. En ple segle XXI mantenim un règim de planificació soviètica poc sensible a la realitat dels nostres dies. Un ciutadà hauria de poder ser capaç d'accedir de forma organitzada a aquells serveis que necessita allà on prefereix del sistema públic, i aquests serveis haurien de ser compensats pels seus costos incorreguts.

PS. Lectura comptable del pressupost 2011. Una organització pot defensar legítimament determinades posicions, però l'oblit intencionat de qui ha provocat els desviaments pressupostaris dels darrers anys fa que la seva veu se l'emporti el vent.

PS. Miro el blog de LSE, hi trobo un comentari d'un llibre sobre Foucault, interessant.