Regulating Managed Care: Theory, Practice, and Future Options

By Stuart H. Altman; Uwe E. Reinhardt et al. | Go to book overview

Chapter Six
The Long-Term Care
Ombudsman Program

A Model for Health Care Consumers
William F. Benson

Ombudsman: (1) a government official (as in Sweden or New Zealand) appointed to receive and investigate complaints made by individuals against abuses or capricious acts of public officials; (2) one that investigates reported complaints (as from students or consumers), reports findings, and helps achieve equitable settlements. —WEBSTER'S NINTH NEW COLLEGIATE DICTIONARY

Few would disagree that our highly complex health care world is rapidly becoming even more complex. The technology of health care is complex, as are its organizational and delivery models and its financing. For consumers, successfully navigating through a health care organization or system to obtain appropriate, timely, and high-quality health care can be a difficult if not daunting chore. At times it can be overwhelming. If the consumer is dissatisfied or unhappy with the care received or feels aggrieved in some way, the effort anticipated or expended in trying to resolve the source of discontent or to settle the grievance may be overwhelming, particularly in the absence of mechanisms for resolving problems.

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