Abstract

This paper engages in the ongoing dialog on "justice and the health care 'industry"'1 and addresses the question of whether market strategies are consistent with an ethical distribution of resources in health care. As it pertains to the development of perinatal services over the past twenty-five to thirty years in the United States, my short answer to this question is "no." Business organization and market-oriented strategies have contributed to the creation and extensive growth of perinatal intensive care centers located in large medical centers. This growth, which has aggravated the neglect of primary care, has been incongruent with known health needs and represents an ethically questionable distribution of resources.