COMMUNITY CONTROL IN A WORLD OF REGIONAL DELIVERY SYSTEMS

The pell-mell restructuring of health care into massive regional deliv ery systems has disrupted long-standing relationships between local le aders and residents and their community health care systems. Tills dim inished role of communities in our new world of health care is ironic. As control within large regions in this country becomes concentrated within the operation of three or four health plans, we become increasi ngly dependent upon oligopolies for our market solutions. As economic arrangements, all that oligopolies can offer are indeterminate outcome s. Some may be good for consumers, others disastrous. Without the I:co untervailing influence of nonmarket community interests, individuals m ay find their satisfaction with the health care system greatly diminis hed.