ABSTRACT
Because no national health program assures entitlement to basic services, advocates must cope with barriers to access on the local level. The authors report several strategies that a community-based coalition has used to improve indigent care in one county. Research strategies have involved short-term investigations of barriers to needed services. Political strategies have attempted to improve the county government's administrative procedures and financial support of services for the poor. Legal strategies have involved the participation of attorneys who represent clients unable to receive care. Although such advocacy efforts do not guarantee access, they can substantially improve the availability of local services.
Subject(s)
Community Health Services/legislation & jurisprudence , Health Services Accessibility/legislation & jurisprudence , Medical Indigency/legislation & jurisprudence , California , Health Policy/legislation & jurisprudence , Humans , Medically Uninsured/legislation & jurisprudence , PoliticsABSTRACT
Access to health care for the medically indigent has emerged as a major policy issue throughout the United States. Because no national health program assures entitlement to basic services, practitioners and patients must cope with barriers to access on the local level. The authors report several separate but integrated strategies that a community-based coalition has used to achieve improvements in indigent care within a single county. Research strategies have involved short-term investigations of barriers to needed services, so that local awareness of the problem would increase rapidly. Political strategies have attempted to improve the county government's administrative procedures and financial support of services for the poor, to modify the practices of local health care institutions, and to influence statewide and national policies affecting local conditions. Legal strategies have involved the participation of attorneys who represent clients unable to receive care and who could initiate litigation as appropriate. Each of these strategies contains weaknesses as well as strengths. Although such advocacy efforts do not achieve a coherent system guaranteeing access, they can substantially improve the availability of local services.
Subject(s)
Consumer Advocacy , Health Services Accessibility , Medically Uninsured , California , Health Services Accessibility/legislation & jurisprudence , Humans , Politics , PovertyABSTRACT
Access to health care for the medically indigent has emerged as a major policy issue throughout the United States. Because no national health program ensures entitlement to basic services, practitioners and patients must cope with barriers to access on the local level. We report several separate but integrated strategies that a community-based coalition has used to achieve improvements in indigent care within a single county. Research strategies have involved short-term investigations of barriers to needed services so that local awareness of the problem would increase rapidly. Political strategies have attempted to improve the county government's administrative procedures and financial support of services for the poor, to modify the practices of local health care institutions, and to influence state and national policies that affect local conditions. Legal strategies have involved the participation of attorneys who represent clients unable to receive care and who could initiate litigation as appropriate. Each of these strategies contains weaknesses as well as strengths. Although such advocacy efforts do not achieve a coherent system that guarantees access, they can substantially improve the availability of local services.
KIE: The authors report on the research, political, and legal strategies used by a community-based coalition to improve indigent access to health care in California's Orange County. Research strategies increased local awareness of barriers to access to care. Political strategies attempted to improve the county government's administrative procedures and financial support of services for the poor, to modify the practices of local health care institutions, and to influence state and national policies with implications for local indigent care. Legal strategies secured legal representation for persons unable to receive care, and persuaded the county to accept responsibility to provide nonemergency care to certain classes of indigents. Mayster, et al. discuss the strengths and weaknesses of these strategies, assess their impact, and offer encouragement to local advocacy efforts.
