AMBULATORY CARE PROGRAM A ROLE FOR THE CONSUMER

On a few occasions the consumer movement was given legislative legitimacy. On those occasions the rationalization for the inclusion among consumers was that the consumer movement forced the legislation to include them. Another view is that providers needed a mask to cover its agenda and if that mask included a role for consumers it was just a part of the horse trading required to feed at the public trough. No real power was ever given to consumers. Whatever rights and power they gained was due to their own ingenuity.

This issue of Health Perspectives documented the involvement of consumers in the Ambulatory Care Program (part of an amendment to the Public Health Law known as the “Ghetto Medicine Act”) initially legislated to offset significant cuts in Medicaid in New York in 1968-9. That legislation reduced payments to physicians and restrictions on eligibility. The result was a growing number of New Yorkers without any medical insurance. The Ghetto Act and the Ambulatory Care Program were made legislatively possible by citizens also known as consumers, blacks, minorities, poor and disenfranchised who put political pressure on legislators. Providers lobbied for these bills which included consumer participation to gain better reimbursement. To ensure passage they felt they had no choice and signed on to grass root consumers having some limited role.