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August 3, 1994

Improving Health Care for the Poor

Author Affiliations

Baylor College of Medicine Houston, Tex

JAMA. 1994;272(5):352-353. doi:10.1001/jama.1994.03520050029015

To the Editor.  —In his recent article, Dr Ginzberg1 describes some of the major access problems facing the poor in the nation's four largest cities. Our city, Houston, Tex, was described as "the most meager in the medical services it offered the indigent." While we certainly acknowledge that we have significant access problems in Houston, we feel that the article does not fully describe the situation and belittles some of the major efforts and accomplishments of the two Houston medical schools and the public hospital system, the Harris County Hospital District (HCHD). In general, the HCHD and the medical schools' involvement with and commitment to it grew steadily throughout the 1970s and 1980s. The quantity and quality of services continue to increase in the 1990s.As Ginzberg correctly points out that the problems of access in the nation's cities will not be solved unless the locus of medical care

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