Two-Class Medicine Returns to the United States: Impact of Medi- Cal Reform
Lancet. 1984 Nov 17; 2(8412): 1144-1146.
Five case studies illustrate the reduction in access to health care for the poor, aged, and unemployed that has resulted from the decreased funding of Medi-Cal, California's public health insurance program. Policy shifts include the replacement of the fee-for-service system with prospective contracts and the transfer of responsibility for medically indigent adults to the counties, where the availability of services varies. The result has been the creation of two-class medicine in which an "inadequately financed and chaotic public system serves the poor, while a friendly and solicitous private sector reaches the well-to-do." (KIE abstract)
Adults; Aged; Access to Health Care; Case Studies; Contracts; Economics; Financial Support; Government; Government Financing; Health; Health Care; Health Care Delivery; Health Insurance; Hospitals; Indigents; Insurance; Medicine; Private Sector; Public Health; Public Policy; Remuneration; State Government;
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