No abstract

A national survey conducted in 1995 found that a disturbingly high percentage of Americans do not understand the basic elements of health plans and that people want much more information, particularly about the physicians in the plans and the range of services that are covered. Their most important concern when selecting a health plan is the quality of physicians in the plan, followed by the courtesy of doctors and staff and the freedom to choose their own doctors and hospitals.

Although community health centers and public hospitals are the most visible safety-net providers, physicians in private practice are the main source of care for the uninsured and Medicaid enrollees. Yet the number of these physicians providing free care is declining, even as the need for their services increases. One promising strategy for halting the decline is to strengthen and increase volunteer health care programs: free clinics and physician-referral networks. This report reviews the state of these programs and suggests ways to improve them. Given the limits of volunteerism, the authors conclude that only national health insurance will solve the problem of the uninsured.

A central challenge in developing reproductive health strategies is giving real meaning to the right of couples and individuals to determine, freely and responsibly, the number and spacing of their children. This article places the right of reproductive choice in legal and historical contexts, highlights salient issues that arise in trying to formulate international standards for its enforcement, and examines two particularly thorny issues: the tension between demographic priorities and reproductive choice and the tension between international standards and local custom/religion. The article calls on health professionals to participate actively in the elaboration of reproductive rights, both through their immediate work in the health-care field and through involvement in the international policymaking process that will take place in three upcoming international conferences.

No abstract