Health Care "Safety Net" in a Post-Reform World

The Health Care Safety Net in a Post-Reform World examines how national health care reform will impact safety net programs that serve low-income and uninsured patients. The “safety net” refers to the collection of hospitals, clinics, and doctors who treat disadvantaged people, including those without insurance, regardless of their ability to pay. Despite comprehensive national health care reform, over twenty million people will remain uninsured. And many of those who obtain insurance from reform will continue to face shortages of providers in their communities willing or able to serve them. As the demand for care grows with expanded insurance, so will the pressure on an overstretched safety net.

This book, with contributions from leading health care scholars, is the first comprehensive assessment of the safety net in over a decade. Rather than view health insurance and the health care safety net as alternatives to each other, it examines their potential to be complementary aspects of a broader effort to achieve equity and quality in health care access. It also considers whether the safety net can be improved and strengthened to a level that can provide truly universal access, both through expanded insurance and the creation of a well-integrated and reasonably supported network of direct health care access for the uninsured.

Seeing safety net institutions as key components of post-health care reform in the United States—as opposed to stop-gap measures or as part of the problem—is a bold idea. And as presented in this volume, it is an idea whose time has come.

MARK A. HALL is the Fred D. and Elizabeth L. Turnage Professor of Law and Public Health at Wake Forest University. He is the author or editor of numerous books, including Making Medical Spending Decisions and Health Care Law and Ethics.

SARA ROSENBAUM is the Harold and Jane Hirsh Professor and founding chair of the department of health policy at the George Washington University School of Public Health and Health Services. An author of more than 350 articles, studies, and health policy reports, she is also a coauthor of Law and the American Health Care System.

MARK A. HALL and SARA ROSENBAUM each contributed chapters to Medical Professionalism in the New Information Age, edited by David J. Rothman and David Blumenthal (Rutgers University Press).