This book addresses important themes in medical sociology, with papers that range from those with an explicit policy point of view to narrower papers on more specific issues in health care delivery. One of the lessons of the past decade is that no countries in the world are completely satisfied with their health care delivery systems nor do they believe they have resolved the tensions of how to provide access to all to high quality care at a reasonable cost INDICE Managed Care Issues and Organizational Features. Surveys of members of health care insurance plans: methodological issues (D.J. Brogan). Organizational variation in the managed care industry in the 1990s: implications for institutional change (D.L. Anthony, J. Banaszak-Holl). Education, managed health care experiences, and health outcomes (J.W. Grimm et al.). The influence of clinic organizational features on providers' assessments of patient adherence to treatment regimens (K. Lutfey). Special Groups of Patients and Health Issues. Inner Strength and the Existential Self: improving managed care for HIV + women through the integration of nursing and sociological concepts (J.A. Kotarba et al.). Paradigm tension in management of chronic disease (N.G. Kutner). Delivering long term care in a changing environment: the impact of managed care in the United States (T.L. Scheid, D.L. Zablotsky). Lessons From Other Countries. Making reform locally: general practitioners, health care managers and the 'new' British health service (K. Clegg Smith). Social capital, health status, and health services use among older women in Almaty, Kazakhstan (T.T.H. Wan, B.Y.J. Lin). Broader Policy Concerns and Health Insurance Reform. Universal health care - an idea whose time has come (E. Furlong). Life after welfare in rural communities and small towns: planning for health insurance (K. Seccombe, R. Lockwood).