Why are healthcare consumers so passive ?

Why are healthcare consumers so passive ? : "'Consumerism is making an impact in every corner of the economy but the doctor's office,' he said. 'And that needs to change if we are to gain control of rising health care costs. The issue is 'value' -- the merging of cost and quality. Americans are unmatched in seeking value in their consumer-goods purchases, and it is critical that the health care system be adjusted to reward a similar degree of diligence.'"