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Health Care Choices in the United States and the Constrained Consumer: A Marketing Systems Perspective on Access and Assortment in Health Care

One of the great American success stories of the twentieth century was the victory of medicine over disease. Its success relied on the emergence of a marketing system that delivered and managed health care. Yet, for all the success of the U.S. health care marketing system, there persists a consumption constraint of access—namely, access for whom and access to what. The purpose of this essay is to explore the effects of marketing systems on provisioning and constraining consumption and to understand the role of public policy in overcoming the constraints in marketing systems.