Do targeted efforts for the rural underserved help kill comprehensive reform?

Journal Article (Review;Journal Article)

There has been a shift during the past 60 years from a broad notion of the entire nation as underserved to a more focused effort to identify particular areas (often rural) thought to be underserved. This approach was formalized with the advent of the war on poverty. This focused approach has been cemented during the past 30 years, in part by the success of various federal health center programs that have remained funded during this period in spite of opposition. This paper concludes that the consensus view that rural underserved areas represent an "exception" phenomenon that is properly addressed with special responses (organizations or physicians) has had two major effects: (1) the political survivability of focused programmatic responses (such as Community Health Centers) has been enhanced; and (2) the existence of an "elastic net" policy network to advocate for the expansion of such remedial efforts may play a contributory role in helping to defeat comprehensive health reform.

Full Text

Duke Authors

Cited Authors

  • Taylor, DH

Published Date

  • January 1999

Published In

Volume / Issue

  • 15 / 1

Start / End Page

  • 55 - 60

PubMed ID

  • 10437331

Electronic International Standard Serial Number (EISSN)

  • 1748-0361

International Standard Serial Number (ISSN)

  • 0890-765X

Digital Object Identifier (DOI)

  • 10.1111/j.1748-0361.1999.tb00598.x


  • eng