Health objectives and health system reform in Iowa: complementary approaches to health planning

Current proposals for health system reform, such as that developed by the Iowa Leadership Consortium on Health care (ILC), call for the creation of agencies responsible for setting rates, monitoring quality and efficiency, and regulating capital investment. These can be described as health planning activities. However, it is planning of a very different nature than that conducted by community groups seeking to achieve the objectives of Healthy People 2000. Yet, despite their apparent differences, modern regulatory planning in the form proposed by the ILC and grass roots planning have at least the following in common: -Both seek to improve the efficiency of the health system in addressing health problems; -Both use population health status data as a basis for planning; -Both derive from a health planning tradition that focuses on restructuring the health care delivery system; -Both assume the legitimacy of the health care reform objectives relating to medical care; -Both may respond to community input regarding the nature of proposed reforms; and -Both may be criticized by radicals for railure to address the root, socioeconomic causes of disease.