ABSTRACT
The United States has long had a pluralistic health care system in which government and the private sector have both been involved in the financing and operation of health care delivery. If anything, the amount of public funding for health care has been increasing at the expense of private spending. Although universal health care has not been adopted in the United States, all Americans have access to essential care through the emergency rooms and clinics of the nation's public and voluntary hospitals. The best ways to delineate the pluralism of New York City's health care delivery system is to consider briefly how the poor obtain access to care, focusing primarily on the provider institutions, from private practitioners to the public and voluntary hospital systems. The larger proportions of Medicaid enrollees receive their ambulatory care at the emergency rooms and clinics of the Health and Hospitals Corporation (HHC) or voluntary hospitals.
