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Forging a Community Health Partnership: Hillsborough County, Florida-Reply

Edward L. Baker Jr, MD, MPH; David Satcher, MD, PhD; Paul V. Stange, MPH
JAMA. 1995;273(15):1173. doi:10.1001/jama.1995.03520390031017.
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In Reply.  —The partnership described by Dr Penzell and colleagues clearly illustrates one of our central points: as managed care (particularly when capitation is a central feature) becomes an increasingly prominent form of medical care financing, private clinicians can succeed ultimately only if governmental public health agencies are strong partners. A central driving force for the new partnership is derived from a shared vision of "healthy people in healthy communities." In this regard, we must emphasize a key point about which Penzell et al are silent. The improvement of community health status will occur only partly as a result of improved access to clinical care by a larger percentage of the population. Even more critical are the maintenance and enhancement of those essential public health services designed to protect and promote the health of the community as a whole (eg, communitywide health status assessment systems, tuberculosis case management), which are


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