by Jurgen Habermas 1. The Concept. By "the public sphere" we mean first of all a realm of our social life in which something approaching public opinion can be formed. Access is guaranteed to all citizens. A portion of the public sphere comes into being in every conversation in which private individuals assemble to form a public body.' They then behave neither like business or professional people transacting private affairs, nor like members of a constitutional order subject to the legal constraints of a state bureaucracy. Citizens behave as a public body when they confer in an unrestricted fashion-that is, with the guarantee of freedom of assembly and association and the freedom to express and publish their opinions-about matters of general interest. In a large public body this kind of communication requires specific means for transmitting information and influencing those who receive it. Today newspapers and magazines, radio and television are the media of the public sphere. We speak of the political public sphere in contrast, for instance, to the literary one, when public discussion deals with objects connected to the activity of the state. Although state authority is so to speak the executor of the political public sphere, it is not a part of it.2 T o be sure, state authority is usually considered "public" authority, but it derives its task of caring for the well-being of all citizens primarily from this aspect of the public sphere. Only when the exercise of political control is effectively subordinated to the democratic demand that information be accessible to the public, does the political public sphere win an institutionalized influence over the government through the instrument of law-making bodies. The expression "public opinion" refers to the tasks of criticism and control which a public body of citizens informally-and, in periodic elections, formally as wellpractices &-d-vis the ruling structure organized in the form of a state. Regulations demanding that certain proceedings be public

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We describe an approach to health care in the inner city: a multidisciplinary system of physicians and mid-level practitioners that provides individualized care to chronically ill, elderly, homebound, and nursing-home residents of urban Boston who would otherwise be forced into an inappropriate reliance on teaching hospitals. Linked to four neighborhood health centers, three home-care programs, and a teaching hospital, and financially self-supporting except for the home-care component, the system cared for 3000 ambulatory, 280 homebound, and 358 nursing-home patients in the representative year described. In-hospital use, particularly hospital days, was reduced when judged by existing data for comparable (though not identical) populations. Based on stable physician practices, the system offers a workable approach to the related problems of care, manpower, and cost in the urban core.

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