Patients vs. consumers: What’s in a name?

Oliver J. Kim1

1 Cross-Border Health, 5100 Columbia Pike, Arlington, VA, USA, 22204,

Following the passage of the Affordable Care Act, the American healthcare system is rapidly transforming in ways that are both exciting but potentially in conflict. On one hand, delivery systems are changing to meet new payer demands for more accountability, greater value, and a focus on managing a population’s health. At the same time, researchers are exploring targeting disease at an individual level using medicine that is “personalized.” In the middle are those receiving care and their caregivers. What is their role in this transformation, what kind of care do they want and need?

To involve the person receiving care, a dichotomy has emerged between two theories of care. On one side is a consumer voice for value and affordability and pushes providers toward improving population health and improving communities. On the other side is a patient voice for access to care and individualized care often associated with research and breakthrough technologies.

Affordability and access are not necessarily exclusive goals, but achieving both can be difficult because we may need to sacrifice one in order to achieve the other. Given this tension, can we bring both to the table and ensure that each voice is heard?

This paper will look at the roles of consumers and patients in the post-ACA era and how they are responding to changes in the healthcare system. First, the proposal will summarize a literature review on how the two terms are used. Second, the proposal will analyze how major advocacy organizations representing one or both of these interests describe themselves and how this affects their public advocacy agenda. Exploring these two concepts will help policy makers and health system leadership ensure that patients, consumers, and the perspective each represents are part of the process of designing the new, evolving healthcare system.


Oliver Kim is the executive director of Cross-Border Health, an organization which compares health policy among industrialized nations. In the United States Senate, he served as the senior health advisor to US Senator Debbie Stabenow and then as deputy director for the Special Committee on Aging under Chairman Bill Nelson. Additionally, Oliver was legislative director for Planned Parenthood Federation of America, overseeing congressional relations for the organization and its affiliates during one of the most critical times in the organization’s history. He was selected for the Woodrow Wilson foreign policy fellowship and the AcademyHealth Health Policy in Action award.

Advanced statements for improved recovery journeys

Ann Jorgensen1, Charlotte Jones2

1 Mental Health Legal Centre, PO Box 12365 A’Beckett Street, VIC, 3008,
2 Mental Health Legal Centre, PO Box 12365 A’Beckett Street, VIC, 3008

For the first time in Victoria the Mental Health Act 2014 (Vic) gives a form of legal recognition to advance planning for people with mental illness. The advance statement provisions provide an opportunity for a person’s treatment preferences to be recorded and taken into account in the event that they are subject to compulsory mental health treatment.

Though the legislation has been in effect for two years advance statements are yet to make a significant impact in the mental health sector. Consumers may be unaware of advance statements or sceptical about the benefits of making one. Mental health services often lack the time and resources to encourage and assist consumers to make them.

The provisions themselves create a fairly weak model with broad override powers and limited avenues of enforcement. There is also minimal information available to assess the impact that an advance statement has on episodes of compulsory treatment.

The Mental Health Legal Centre’s Advance Statement Project aims to increase the uptake of advance statements and to assess their effectiveness in improving individual’s recovery journeys. Regular legal clinics have been established at a number of mental health services to provide independent advice and assist people to make advance statements. These clinics are supported by a comprehensive community legal education program targeting both consumers and practitioners.

The project maintains regular contact with clients once their advance statements are completed to track the impact that the advance statement has on future treatment (whether voluntary or compulsory).

This presentation will reflect on the first year of the project in examining the role that advance statements can play in supporting individual decision-making and improving outcomes.


Ann is the Principal Solicitor at the Mental Health Legal Centre overseeing two health justice partnership projects – one involving advance statements and the other delivering legal services to clients of the Royal District Nursing Service Homeless Person’s Project. She has a background in community law and legal policy. She is currently completing a Master of Laws at the University of Melbourne. In 2015 Ann undertook an internship at the International Agency for Research on Cancer in France.

About the Association

The Australasian Association of Bioethics and Health Law (AABHL) was formed in 2009.

It encourages open discussion and debate on a range of bioethical issues, providing a place where people can ask difficult questions about ideas and practices associated with health and illness, biomedical research and human values.

The AABHL seeks to foster a distinctive Australasian voice in bioethics, and provide opportunities for international engagement through its membership, journal and conferences.

Members come from all the contributing humanities, social science and science disciplines that make up contemporary bioethics.

Many members have cross-disciplinary interests and all seek to broaden the dialogues in which all members of the wider community ultimately have an interest.

The AABHL is a supportive, creative and challenging community that provides a rich source of continuing academic refreshment and renewal.

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