This article examines the medical care sector in New York City in the wake of that city's fiscal crisis. Against a changing national background of medical care politics, it describes existing inequalities and distortions in the medical care system, a system whose inequities are partially reinforced by federal and state intervention. The process of subordination of the 'place-of-last-resort' public sector is defined. Although attention on this sector is justified, the service crisis of the medical care sector is more correctly to be seen as one afflicting all those services used by minorities and the working class. The policy of retrenchment in New York is seen as a prelude to Reagan's austerity programme, and calls for reassessment of current health activism.
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