a. I was surprised to read that increased competition among practitioners may lead to practice changes such as increased office hours, home visits, and more time spent with patients. This makes sense, but because each chapter up to this point discussed how the medical field expanded in a way that wasn't beneficial to patients always, it was interesting to learn about a shift which may occur in the opposite direction.
b. I agree that the independent small businessman is "firmly rooted in the American imagination." Many people think of this as the "American Dream." I also agree with the author that large corporations have kicked him out of the American economy, if he ever had a place in it.
c. I disagree with the author's statement that "images of the future are usually caricatures of the present." I do not think this is true. Many people extrapolate on events of the past and present to predict the future.
d. Something I have witnessed is the diminishing resources which the author discusses in this chapter. We have seen that the NC state budget has been frozen in terms of raises for several years. Programs are being cut from state colleges, and HMOs are becoming more popular as ways of managing financial expenditures.
e. I am looking forward to observing the rise of corporate enterprises in health services. In the last chapter, the author discusses how this might effect the medical field. This will likely result in savings. Corporate enterprises tend to know how to manage money, and may be a good intermediary between government programs and the health care field. This savings in money may come at a cost to other services, but there may also be a shift to saving money in the long-run, such as through preventative care.
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