Urban Health Services

This book is a collection of essays prepared as reports of studies by the staff of the Conservation of Human Resources Project at Coluimbia University. It is fleshedI out witlh introdluctory comments and conclusions by the director of the project, Professor Eli Ginzberg. It is Ginzberg's unifying conceptualization that binds the essays togetlher: "An evaluative review of efforts to improve healtlh services in New York City and( of the successes achieved an(d the failures registered is one important way of acquiring knowledge about the factors wllich facilitate or retard improvement." The material presented may be of interest in itself (and it is), but one must assess the value of the book on the applicability of the information from New York City to the rest of the cities in the United States and, in adldition, make some judgmenit as to whetlher or not playing down the role of national patterns of financinig ancl organization of healtlh services and the role of the Federal establislhment lhasni't limited the usefulness of the information collected. Even if the last tlhing a deep sea fish were to discover would be water, as Sir Oliver Lodge is said to have observed, it doesn't lessen the importance of water to deep sea fislh. If New York's experience is not pregnant wvitlh meaning for futture action because the experience will be or can be manipulated from a different fulcrum, then the ljook is an interestiing academic exercise but lhardly a social contribution. Professors and( their staffs these (lays are fortunate in that they can make judgments about healtlh service needs and their fulfillment witlhout having to be burdened with the consequences. Economists, like historians, really ought to get "tlheir hiistorical priorities in ordler." Wlheni Ginzberg says, "the healtlh manpower complex lhas adlapted not badly" (the quote is from a summary paper on this same exercise) he is a little out of touch. It is of a piece with his customary relaxed attitude about manpower-tlhat there will always be shortages, thlat medical care doesn't help that much anyway, and that people ought to learn to get along with less. Yet this does not come to grips with the increasing angry frustration of larger and larger segments of the population. The conclusions in Professor Ginzberg's final chapter are a little puzzling. A mixed lot of pithy apothegms, some are so trite as to be meaningless: "Pluralism operates as both potential for and constraint on reforming the healtlh system." "The effectiveness of government's intervention depends on its strategy and tactics." "Basic and applied research capabilities in healtlh systems analysis must be strengthened." "Political leadership and administrative stability are important