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Abstract

The fact that national health care reform in the United States has been stalled is not reason for resign. More than ever, one has to design and implement creative options to achieve satisfactory health service at low costs. The political turnover in Congress shifts more responsibility to local governments. This means less funding and less willingness by the national government to be held accountable for health and social services. On the other hand, this situation may carry opportunity to impact social policies on a local level.

The living conditions in some of our communities equal those in so-called third world countries. It is well known that New York City's infant mortality rate, for instance, surpasses that of Bangladesh. A main reason for these dismal conditions is the neglect by federal and regional policymakers. Another is the sentiment among the general public of not feeling responsible for the well being of their fellow citizens (or "only" fellow human beings, as has been demonstrated by the voters' support for proposition 187 in California). Those affected complain they are forgotten and insist on the government's provision of social services. .

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