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February 16, 1994

Changing US Health Care: A Study of Four Metropolitan Areas

Author Affiliations

UCLA School of Public Health Los Angeles, Calif

JAMA. 1994;271(7):560-561. doi:10.1001/jama.1994.03510310092055

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The Reagan era began in 1980 with a policy to limit federal spending, promote competition and the free market, and encourage local control in the health services sector. The authors of this volume attempt to trace the influence of this policy in the decade of the 1980s in the four largest metropolitan areas of the country: New York, Chicago, Los Angeles, and Houston.

In fact, the studies of the metropolitan areas were conducted by people other than the primary authors except for Berliner (who authored the chapter on New York): J. Karen Salmon—Chicago; E. Richard Brown and Geraldine Dallek—Los Angeles; and Hardy D. Loe, Jr, Virginia C. Kennedy, and Frank I. Moore—Houston.

The plan was to examine similarities and differences in the metropolitan areas. Similar forces acting in all areas included federal efforts to increase Medicaid coverage for pregnant women and children; the growth of the uninsured population and change

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