5176.0: Wednesday, November 15, 2000 - 3:30 PM

Abstract #8452

Privatization, managed care, and eliminating health disparities: will "de-mega-mergers" and other strategies work?

Pauline J. Kelzer, DrPH and Barbara A. D'Anneo, BS. Department of Nursing and Health Sciences, California State University Hayward, P. O. Box 7933, Berkeley, CA 94707, (510) 223-4790, pkelzer@ibm.net

Healthcare systems in Northern California experienced the same pressures for privatization as other systems. Mergers, acquisitions, conversions to for-profit status, de-districting, and transfers have all been responses to privatization pressures. However, in many cases the consumer backlash and the anti-privatization movement either held the line, re-districted, or generated new legislation to regulate conversions. Employed consumers did not substantially lose access to quality care because they organized and struggled to keep it. However, many scholars agree that unemployed, publicly insured, or low income consumers lost access to quality care, and the disparity gap widens with privatization.

Attempts to block privatization with appeals to the Feceral Trade Commission, the Attorney General and other regulatory agencies are common. The first case of "de-mega-merging" appeared in Northern California when the news broke of the dissolution of the mega-merger between the two giant health care systems of Stanford University and the University of California San Francisco. Eliminating health disparities was not given as one of the reasons for de-merging.

How have Northern California community health care systems fared in the privatization movement? What has been their impact on eliminating health disparities as they reorganized and merged throughout the 1990's? Do any health care systems in Northern California serve as a model for eliminating disparities? This study analyzes some of the more effective health systems in Northern California that have dealt creatively with pressures to privatize and found methods of eliminating health disparities.

Learning Objectives: 1) Identify impact of managed care and privatization on eliminating health disparities; 2) Assess effectiveness of structural and organizational guarantees for consumer satisfaction with access to quality care; 3) Determine role of regulatory agencies in serving as guarantors of access to quality care for unemployed, uninsured, or low income patients

Keywords: Managed Care, Access to Health Care

Presenting author's disclosure statement:
Organization/institution whose products or services will be discussed: Various Northern California health care systems as case study material
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.

The 128th Annual Meeting of APHA