THE HEALTH-CARE BUREAUCRACY - SMALL CHANGES, BIG CONSEQUENCES

Administrative changes have been reshaping health policy for the past decade. One consequence is a more constrained medical profession. Anot her is a more powerful health care bureaucracy. Most industrialized na tions have called on democratic principles to balance professional nor ms; in contrast, Americans are developing a distinctly bureaucratic he alth care regime. This article suggests why and explores the ramificat ions for both the politics of health care and the practice of medicine .