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March 1980 (Volume 58)
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Representation and competition, as democratic and market strategies, have been of small consequence in producing significant improvement in medical care. Membership in an HMO is a greater source of consumer power than is representation in an HSA. Regulation and competition will continue to have limited-often ironic and incoherent-results in the absence of new institutional structures for reform.
Author(s): Paul Starr
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Volume 58, Issue 1 (pages 166–172) Published in 1980
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The Milbank Quarterly’s multidisciplinary approach and commitment to applying the best empirical research to practical policymaking offers in-depth assessments of the social, economic, historical, legal, and ethical dimensions of health and health care policy.