Value based competition in health care’s ethical drawbacks and the need for a values-driven approach

• Main Authors: A. Stef Groenewoud, Gert P. Westert, Jan A. M. Kremer
• Format: Article
• Language: English
• Published: BMC 2019-04-01
• Series: BMC Health Services Research
• Subjects: Value based health care; Ethics; Patient values; Values driven health care; Indicators; Trust
• Online Access: http://link.springer.com/article/10.1186/s12913-019-4081-6

Abstract Value Based competition in Health Care (VBHC) has become a guiding principle in the quest for high quality health care for acceptable costs. Current literature lacks substantial ethical evaluation of VBHC. In this paper we describe how a single-minded focus on VBHC may cause serious infringements upon at least four medical ethical principles: 1) it tends to neglect patients’ personal values; 2) it ignores the intrinsic value of the caring act; 3) it disproportionately replaces trust in professionals with accountability, and 4) it undermines solidarity. Health care needs a next step in VBHC. We suggest a ‘Values-Driven Health Care’ (VDHC) approach that a) takes patients’ personal values as prescriptive and guiding; b) holds a value account that encompasses health care’s intrinsic (gift) values; c) is based upon intelligent accountability that supports trust in trustworthy professionals, and d) encourages patients to raise their voices for the shared good of health care.