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Public Policy and Administration


Christopher B. Jones


The patient-as-consumer has emerged as a narrative in the government health care system that cares for beneficiary veteran patients, elevating the phenomenon of choice in health care legislation and administration. The problem of the submerged state of a health policy was the issue examined within the context of access to health care and what patients experience when choice is present. The purpose of this study was to explore the motivations of beneficiary veteran patients to choose a preventive care option, a seasonal flu shot, at a private sector retail pharmacy rather than at their government health care provider, with the goal of understanding what social marketing strategies supported their decisions, how they defined choice, and what they expected from their choice option. Research questions focused on reasons for patients’ decisions to choose outside preventive care within the context of a social marketing campaign and their interpretation of choice in health care policy. Drawing on the policy feedback theory, an interpretative phenomenological approach was employed. Purposive semistructured interviews of 7 patients were conducted. Data were analyzed using a 3 step process that included descriptive theme-centered coding, emergent sub-coding, and a clustered coding analysis. Two key themes emerged: first, choice in health care policy is relative to a patient’s individual circumstance, and in order to have choice, one must have options; and second, veterans value their earned health care benefits and trust their government provider. Implications for social change include policy maker awareness of the importance of social marketing as a tool for communicating a health policy and legislation so they can make more informed decisions and veterans can feel empowered as patients.