The United States is experiencing a decline of the middle class. What does this trend imply for the future of organizations such as (a) the U. S. Public Health Service, which operates many inner-city health clinics for the economically disadvantaged, and (b) the Scripps Clinic, a large multispecialty group practice in Southern California? For years, the Scripps Clinic was an exclusive medical provider known not only for treatment but also for its research.
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