Abstract
American society has been frequently described as pluralistic in its approach to many of its services. Though this has not been true of most public health services as we have traditionally known them in our country, it is certainly the case so far as personal health services are concerned. Though the formal sponsorship varies-from private profit to private voluntary, to fairly direct representative consumer control, to public corporation, to local, state and federal government-the field as a whole is, at present, clearly provider oriented. How can we best appraise the role and influence of these diverse types of sponsorship? What is the nature of the evidence? Where is the evidence? The literature is uneven and fragmentary and it contains some, but not much, hard scientific data. We must also turn, therefore, to the evidence that derives from historical perspective evaluated in the harsh light of the realities, the needs and expectations of our society today. And I would be imperceptive indeed if I did not clearly recognize that I cannot avoid being affected by the insights I have developed as a result of my life's experience in responsible roles in the private solo practice of medicine, in state and local health departments, in universities and their teaching hospitals, in the organization and administration of consumer sponsored personal health care programs and in health services research.
Published Version
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