Insurers are starting many more HMOs. Even individual doctors in small group practices are now being forced to take capitation payments for insured patients. We know that there are many ways that the three major elements of social stratification affect health status. This panel would be more interested in working toward an integrated perspective, than in simply reporting on race, class, and gender differences. We have learned a lot about health care-seeking and illness behavior by studying interaction and negotiation.
People take varying control of their health problems.
Some are very compliant patients, while others are questioning consumers. No matter how involved they want to be in their own care, people bring to medical encounters their own backgrounds, desires, and interests, and this tells us much about the kinds of care they will receive. Health professionals also differ in their quality of interaction and in their acceptance of negotiation. Our field has studied these issues for many years, but the recent changes in the health care system may produce changes in health interactions.