Reforming gendered health care: An assessment of change

Health policy in the United States has changed dramatically over the past t hree decades, with the main concern shifting from expanded health care cove rage to containment of health care costs. The current focus on providing co st-effective health services, reflected in the growth of managed care initi atives, has elevated concern about the quality of health care. The authors contend that quality of health care has always been the key focus in the wo men's health movement, which evolved in the late 1960s as the first signifi cant challenge to modern medicine. In this article, they apply the analytic lens of gender to develop a fresh perspective on U.S. health care organiza tions and policies, examining the six broad demands of the feminist consume r model of health care, all of which hinge on the issue of quality care for women, to determine whether women's health needs are now being better addr essed. The authors conclude that, despite some notable gains in the roles o f women as consumers and providers of health care, many of the new health r eforms have replicated and solidified the historical inequities in the heal th care system.