ABSTRACT
Regionalization of health manpower, in the sense both of distributing appropriate manpower with reasonable equity and efficiency across the face of the United States and of ensuring adequate care at the local level, has become a topic enmeshed in the broader power plays of health care development. Regionalization of health manpower is of central importance to any discussion of regionalization of health services. "Regionalization" as applied to rural care has two distinct problems: staffing rural and other underserved areas by insuring adequate personnel; and coordinating multi-specialist care within the larger service areas of specialists. The federal approach to the regionalization of health manpower through regional health services has thus been both spotty and coy. The federal government has become a major contributor to health manpower: directly in grants to health manpower education and indirectly through subsidizing professional incomes in massive federal reimbursement schemes for medical care, notably Medicare and Medicaid.
