The health planning process: are consumers really in control?

This study of the governing board of a Health Systems Agency tends to support those who argue that a numerical majority of consumers does not guarantee consumer control of the decision-making process. Empirical support stems from the fact that consumers, relative to providers, appeared to be at a decided disadvantage in three areas: 1. Consumers see themselves as experiencing greater communication problems. 2. Consumers are more likely to perceive their knowledge as being inadequate. 3. Consumers are more likely to feel intimidated by other governing board members. The consumers' disadvantages in these three areas likely diminish the amount of influence they hold. Indeed, both provider and consumer board members felt consumers held less than one-fourth of the influence on the governing board. Although consumers wanted more influence they did not desire majority control. Staff was seen as exerting most of the influence within the HSA.