Jones D R
Community Service Society of New York, NY 10010, USA.
J Urban Health. 1998 Jun;75(2):430-7. doi: 10.1007/BF02345113.
Unique problems in obtaining adequate health care face poor urban communities. These include the rising number of uninsured, abuses in the managed-care system, the unwillingness of private providers to deliver health care for either Medicaid recipients or the uninsured, and an insufficient supply of primary care physicians in minority neighborhoods. If the managed-care system is to bring decent health care to poor urban communities, it must avoid the mistakes of the past. The health care system must be community based, oriented toward primary care, sufficiently funded, and universally accessible. There needs to be better coordination between medical schools and community health requirements and better support for public health facilities. Without adequate health care for the poor, urban living will eventually become more onerous for all.
贫困城市社区在获得充足医疗保健方面面临着独特的问题。这些问题包括未参保人数不断增加、管理式医疗系统中的滥用行为、私立医疗服务提供者不愿为医疗补助接受者或未参保者提供医疗服务，以及少数族裔社区的初级保健医生供应不足。如果管理式医疗系统要为贫困城市社区带来体面的医疗保健服务，就必须避免重蹈覆辙。医疗保健系统必须以社区为基础，以初级保健为导向，资金充足且普遍可及。医学院校与社区卫生需求之间需要更好的协调，对公共卫生设施也需要更好的支持。如果穷人得不到足够的医疗保健，城市生活最终将对所有人变得更加繁重。
