ABSTRACT
Historians have cited several previous turning points in health care: successful breakthroughs in bacteriology, the introduction of aseptic surgical techniques, the professionalization of medicine, advances in anesthesia, and discoveries in immunology. A revolution of equal import can now be seen to have occurred in the 1980s with the introduction of Medicare's Prospective Payment System, which accelerated reappraisal by the insurance industry of traditional fee-for-service reimbursement for all beneficiaries, not just the elderly. Despite the public fear of "managed care", as proposed in the Clinton legislation, capitated payment in the form of Health Maintenance Organizations and Preferred Provider Organizations is a rapidly growing phenomenon. "The Health of the Haight-Ashbury" is not only important historically but illuminates the ongoing issue of class differences in health care and attitudes toward treatment of Americans marginal to mainstream medicine.
