Cole C A
Urban Health. 1982 Aug;11(7):36-9.
In coming months, county governments in California will begin implementing regulations enacted by State Assembly that will change the settings for treatment of Medi-Cal (Medicaid) patients. The change will be dramatic, channeling medical assistance patients out of the offices of individual private practice physicians and into the offices of salaried doctors in public health settings or offices of doctors participating in organized health plans. Negotiated contracts with counties, institutions and non-institutional providers, patients, and fixed rates of reimbursement will become the parameters of medical service for providers of health care in the state's medical assistance program. For urban private solo practitioners in California whose practices rely heavily on publicly-supported patients, these changes hold a major threat, and for physicians throughout the nation it is a situation which should be watched carefully, because California is well known as a state which gives birth to changes that later appear in other states.
在未来几个月里，加利福尼亚州的县政府将开始实施州议会颁布的法规，这些法规将改变医疗补助（医疗救助）患者的治疗环境。变化将是巨大的，把医疗救助患者从个体私人执业医生的办公室转移到公共卫生机构中拿薪水的医生办公室或参与有组织健康计划的医生办公室。与县、机构和非机构提供者、患者协商的合同以及固定报销率将成为该州医疗救助计划中医疗服务提供者的医疗服务参数。对于加利福尼亚州那些严重依赖公共资助患者的城市私人独立执业医生来说，这些变化构成了重大威胁，而对于全国的医生来说，这是一种应密切关注的情况，因为加利福尼亚州是一个以率先产生后来在其他州出现的变化而闻名的州。
