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Edward L. Baker, Jr, MD, MPH; David Satcher, MD, PhD
Centers for Disease Control and Prevention Atlanta, Ga

Paul V. Stange, MPH
Association of Schools of Public Health Atlanta, Ga

JAMA. 1995;273(15):1173.

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In Reply.

—The partnership described by Dr Penzell and colleagues clearly illustrates one of our central points: as managed care (particularly when capitation is a central feature) becomes an increasingly prominent form of medical care financing, private clinicians can succeed ultimately only if governmental public health agencies are strong partners. A central driving force for the new partnership is derived from a shared vision of "healthy people in healthy communities." In this regard, we must emphasize a key point about which Penzell et al are silent. The improvement of community health status will occur only partly as a result of improved access to clinical care by a larger percentage of the population. Even more critical are the maintenance and enhancement of those essential public health services designed to protect and promote the health of the community as a whole (eg, communitywide health status assessment systems, tuberculosis case management), which are . . . [Full Text PDF of this Article]

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