2003 Reports

"Active Patients" in Rural African Health Care: Implications for Welfare, Policy and Privatization

Leonard, Kenneth L.

The 'active patient' is introduced in this paper. She is the same person as the rational peasant that we have known for at least three decades. She is a rational agent seeking health care in an environment characterized by market failures (particularly agency in the supply of medical quality) and imperfect institutional responses to these failures. We show evidence that patients significantly increase their welfare by choosing between various different providers and matching their illnesses to the resources that are available at these different providers. This paper suggests that continuing to view patients as passive participants in the health care market gives way to misleading policy suggestions and may in fact reduce the welfare of patients.