Health care is shifting from a professional-independent to a business-bureaucratic orientation. Both professional and business ideology have been unfavorable to the development of self-care and a strong health care role for families. But business ideology contains more loopholes for the emergence of a higher level of family self-care activity. The shift forces consumers to take a cautious posture in the marketplace, encouraging active management of their own health care. Hoivever, families will obtain government support for their self-care activities and a policy-influential role in health system governance only through organized political action.
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