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February 9, 1994

Improving Health Care for the Poor: Lessons From the 1980s

Author Affiliations

From The Eisenhower Center for the Conservation of Human Resources, Columbia University, New York, NY.

JAMA. 1994;271(6):464-467. doi:10.1001/jama.1994.03510300070041

ALTHOUGH the details of the Clinton Health Security Plan have yet to be debated and acted on by the Congress, it is reasonably certain that the country is on its way to providing coverage for essential health care services to all Americans. Accordingly, it may be both timely and helpful to report the findings of a study of the changing US health care delivery system seen through the mirror of the nation's four largest metropolitan areas—New York, NY, Chicago, Ill, Houston, Tex, and Los Angeles, Calif. The study was undertaken by the Eisenhower Center staff at Columbia University, New York, in the late 1980s in collaboration with three field associates with the support of the Robert Wood Johnson Foundation.1 Our primary focus was the changing structures for delivering health care services to the poor, and we believe that the findings hold lessons for the nation as it seeks to