Consumer participation and community organization practice: implications of national health legislation

This paper reviews ten federal health laws from the perspective of the extent to which consumer participation had been incorporated as an integral aspect of health program, identifies some issues and dilemmas of implementing consumer participation activities, and offers suggestions for the involvement of consumer advocates. The review of the laws showed uncertainty of outcomes, conflicting philosophies, conflicting purposes, conflicting strategies, and conflicts relating to representativeness, legitimacy and consumer role. Despite the inconsistent record of Congress to legislate consumer participation, two recent health laws, P.L. 93-641 and Title III of P.L. 94-63, appear to offer major opportunities in promoting consumer involvement in planning and policy development activities. However, because these laws continue to delegate the responsibility for implementing consumer involvement programs to providers, established institutions and state agencies, consumer advocates are urged to increase their knowledge of the laws and to assist consumers to realize their right of self-determination. The cause is worthy and represents a desirable goal for public health--and in the final analysis, for the survival of our democratic society.