In the selective contracting era, consumer choice has generally been absent in most state Medicaid programs, including California's (called Medi-Cal). In a setting where beneficiary exit is not a threat, a large payer may have both the incentives and the ability to exercise undue market power, potentially exposing an already vulnerable population…

In California, school districts are categorized as public health screening centers and are required to have school doctors or school nurse practitioners provide complete physical examination services. A survey was conducted in a school district with an enrollment of about 12,000 students to determine parental attitudes toward this service, and…