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The newly competitive health care system reflects both an excess supply of health care providers and a greater sensitivity to price among those purchasing health services. These dual pressures are felt in public programs as well as in private markets. A competitive ethos is also changing popular expectations of the appropriate relation between health care institutions and their communities. These changes offer opportunities for enhanced access to health care for some black Americans, but portend dire restrictions on access for the least-advantaged blacks. They also threaten to reduce significantly the influence exerted by black communities over their local health care providers.
Author(s): Mark Schlesinger
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Volume 65, Issue S2 (pages 270–296) Published in 1987
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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.