Over the past years there has been increasing interest in a variety of health sector issues that can be subsumed under the heading of "accountability." Because it receives so much tax money each year, there is the growing sense in government and to a lesser extent, as we shall see, among consumers that the health sector has an obligation (1) to account for how the money is spent, (2) to demonstrate that the money is spent as well as possible, and (3) to show that these expenditures meet the needs of consumers.

This article examines this proposition from the perspective of the consumer and addresses some of the more significant issues:

What are the healthcare issues for the consumer?

1. How reliable are consumers as reporters of their experiences in, and the operations of, the healthcare sector, and hence as sources of information for a report card?
2. How reliable are consumers in assessing the quality of care they receive, particularly in hospitals, and the effectiveness and efficiency of expenditures in the healthcare sector?
3. What are some of the "political" implications of reporting information received from consumers?

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