The right to health care - Gains and gaps

The impact on health services of the individual rights and collective responsibility embodied in the U.S. Constitution is examined in the areas of environmental protection, development of health resources, personal health promotion, and social financing of health care costs. Patterns of delivery of health care have shifted from predominantly individualistic ambulatory care to group practice increasingly associated with the prepayment of costs and the establishment of community health centers. Problems remain in the need for more integration of medical and social services in institutions and in the community, more comprehensive community health centers not restricted to the poor, and quality control measures to regulate health maintenance organizations. The role of the law in advances in health care and the achievements of the American Public Health Association are also discussed.