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Unmanageable CareAn Ethnography of Health Care Privatization in Puerto Rico$
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Jessica M. Mulligan

Print publication date: 2014

Print ISBN-13: 9780814724910

Published to NYU Press Scholarship Online: March 2016

DOI: 10.18574/nyu/9780814724910.001.0001

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Complaints

Complaints

The Wrong Glucometer … Again!

Chapter:
(p.151) 5 Complaints
Source:
Unmanageable Care
Author(s):

Jessica M. Mulligan

Publisher:
NYU Press
DOI:10.18574/nyu/9780814724910.003.0006

This chapter explores the contradicting nature of private companies with regards to protecting their beneficiaries, highlighting that the companies themselves violate one's rights through their complaints system. In a market-based health care system, consumers are supposed to express dissatisfaction through purchasing decisions like opting to join a higher-performing health plan or to visit a better-rated doctor. Members of private Medicare plans can and do complain but with more significant regulations in place for Medicare health plans that govern the receipt and processing of consumer complaints. Drawing from interviews with Medicare beneficiaries, the chapter notes that the consumer complaints system appears to help beneficiaries however, in reality, it limits beneficiaries' rights and avenues to redress because it narrowly channeled how beneficiaries were permitted to complain, to whom they may complain, and finally what kinds of issues were deemed legitimate and actionable.

Keywords:   private companies, beneficiaries, complaints system, market-based health care system, health plan, Medicare, complaint, consumers

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