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May 9, 1977

A Right to Health: The Problem of Access to Primary Medical Care

Author Affiliations

Case Western Reserve University School of Medicine Cleveland

JAMA. 1977;237(19):2126. doi:10.1001/jama.1977.03270460116039

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This book is a documented evaluation of legislative and other social programs (most of which were launched during the 1960s) that aim to increase access to primary health care. Although the authors find some bright spots and useful lessons, they indict the fragmentary, uncoordinated, and inadequate way we have gone about this business.

Particularly wasteful has been the almost universal failure to include requirements for evaluation in new social legislation. The heart of the present book is the central section in which Charles Lewis, MD, a specialist in health services research, presents the limited data we have available with which to evaluate the various programs. Six of these he classifies as designed to improve the supply of services. Here the record is very disappointing. A marked increase in the numbers of physicians trained, practice commitment, with or without loan forgiveness, rural preceptorships for medical students, and the National Health Service