[Skip to Content]
[Skip to Content Landing]
July 10, 1987

Can Access Be Improved While Controlling Costs?

Author Affiliations

Rye, NY

Rye, NY

JAMA. 1987;258(2):270-271. doi:10.1001/jama.1987.03400020112049

This article is only available in the PDF format. Download the PDF to view the article, as well as its associated figures and tables.


On the surface, this book is a straightforward, in-depth evaluation of a major health care provision project carried out in five cities between 1978 and 1984. But behind its cold tables and statistics, a reader gets a sense of the human values invested in the project, of the hopes— and disappointments—that accompanied it.

The dream was a noble one, posing the question: Can a better way be found for providing health services to the inner-city poor? The stimulus for the Municipal Health Services Program (MHSP) project came, like many other good ideas these days, from the Robert Wood Johnson Foundation, which contributed $3 million to each of five sites for the planning and start-up costs of establishing inner-city primary care centers. A second funding source was the Health Care Financing Administration, which arranged for a waiver program that would encourage people to use the primary care centers (by forgiving the