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STATE PUBLIC HEALTH DEPARTMENTS AND CHANGES IN FEDERAL POLICIES: MANAGED CARE, WELFARE REFORM, AND PRIVATIZATION

This manuscript draws a linkage to United States federal policy and the resulting trend towards greater privatization of state public health services, Medicaid managed care and welfare reform. Findings suggest that the consolidation of publicly funded health services under the auspices of a small number of corporatized Managed Care Organizations (MCOs) has severely constrained the choices available to Medicaid/Medicare recipients and that such adversely affects rural communities and racial/ethnic minorities. Findings also suggest that public health departments are being reduced to training academies for the higher paying MCOs and thus public health department officials are advised to redefine their roles as public advocates for vulnerable, marginalized communities and individuals