Charge of the right brigade? Communities, coverage, and care for the uninsured.
The Robert Wood Johnson Foundation's Communities in Charge (CIC) program funded projects in fourteen communities that aimed to expand health insurance coverage and improve care for their uninsured residents. Our examination of seven program sites suggests that despite solid community leadership and carefully crafted plans, political, economic, and organizational obstacles precluded much expansion of coverage and constrained reforms. Redistribution of financial and organizational resources among both mainstream and safety-net institutions in these communities was hard to achieve. CIC's record offers little evidence that communities are better equipped than are other sectors of U.S. society to solve the problem of uninsurance.
Brown
Lawrence D
LD
Department of Health Policy and Management, Mailman School of Public Health, Columbia University, New York City, USA. ldb3@columbia.edu
Stevens
Beth
B
D018672:Community Health Planning / Q000458:organization & administration*; D003153:Community Health Services / Q000191:economics / Q000458:organization & administration*; D006297:Health Services Accessibility / Q000191:economics / Q000458:organization & administration*; D006302:Health Services Research; D006801:Humans; D019458:Insurance Coverage; D007857:Leadership; D017057:Medically Uninsured; D015397:Program Evaluation; D040841:Resource Allocation; D012307:Risk Factors; D012959:Socioeconomic Factors; D014481:United States