Is a Public Health Orientation Needed to Redress the Organization of Personal Health Care Delivery?
Elena Padilla, PhD, St. Barnabas Hospital, Third Avenue and 183rd Street, Bronx, NY 10457-2594, 718-960-6526, ele_palaw@stbarnabas-ny.org Since mid century the health arena has undergone successive upheavals — from rapid growth and development stimulated by public policies to retrenchment with an attenuated role for government, with public policy turning to cost containment and advancing a market orientation in the midst of massive economic, social and political changes. Meanwhile, market failures in health care delivery burgeon with multibillion dollar acquisitions and megamergers and increases of the uninsured (Bond, F., and Weissman, R., The cost of mergers and acquisitions in the US health care sector. Int. J. Health Services 27(1):77-87:1997, p.77). Market perspectives in health care have also contributed to discounting the public significance of public health while magnifying that of personal health care in the body politic, while economically, access to health care and to healt
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