39

Market-based health care reform modifies the doctor-patient interaction which is at the center of the health sector. Patient roles have become more active and well-informed, giving a new status to the patient as a consumer. The voice of the health democracy signaled the “exit” of patient consumerism. Given that the sovereign consumer can more easily evaluate standardized health products, the endeavor to build a market needs a new conception of health care, in order to take into account the advent of evidence-based medicine. This market-based normativity impacts deontological rules. Increased consumerism and commodification of health care lead to the development of medical liberalism which impacts both efficiency and equity.