Description: Health care provision in the United States remains a critical policy issue. Despite large-scale organizational transformations in hospitals, changes in the ways that health care is delivered, and changes in the relations between patients and the staffs who provide health care services, health institutions remain financially unstable even as they have grown in size. Mergers and new networks and systems have emerged, and revenue streams continue to grow. Experts no longer view such developments as holding the answer to continuing problems of the health care system.

Focusing on changes in the health care sector in New York City during the 1990s, this volume considers physicians and other health care workers, primary and ambulatory care sites, and hospitals and medical centers. It explores the impact of institutional realignments and managed care in New York City. It examines the accelerated destabilization of health care financing and delivery at the end of the twentieth century in the nation at large as well as in New York State and New York City. Ginzberg and his colleagues describe what might happen in the next decade in the nation's largest metropolis and locate the probable outcome as falling between these two extremes. They focus on how the health marketplace may be altered by 2010 when it faces its greatest challenges, a year before the first members of the baby boom generation become eligible for Medicare.

This literate and informative volume elucidates changes that have occurred in the health care sector during the decade of the 1990s and offers an expert assessment of what might happen over the next decade. Policymakers, health care officials, and medical personnel will findthis highly informative reading.

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