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Public Health and Private Profit

A Witch's Brew

By Manjusha P. Kulkarni, Susan Fendell & Erica R. Berry

Analysis of privatization in three settings—administration of eligibility and initial appeals in California's State Children's Health Insurance Program, mental health managed care in Massachusetts' Medicaid program, and the conversion of public hospitals into private entities—highlights several ways privatization can undermine access to health services, the quality of services, the fairness of dispute-resolution processes, and accountability for public funds. Advocates can take steps to protect health services for the poor in a privatized delivery system.

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