Abstract
I seek to understand two dimensions in the evolution and practices of medical institutions in the USA. First, I ask, how and why do medical organizations limit, suspend, or redirect profit-oriented functions to abide by principles of altruism and still survive in a competitive market economy? Reaching out to poor and immigrant populations entails non-economic factors, including the deployment of religious and humanitarian narratives. Conversely, the extent and character of legislative actions supporting philanthropic endeavours is closely related to mobilization at the grassroots level. I investigate the ways in which community organizations bring about changes to support practices that confound, at least to some extent, market expectations and underscore the significance of political action to secure health care services on behalf of low-income populations, including immigrants.
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