This report, written by a pair of USC public administration PH.D's explores the impact of sector choice on the quality, cost and shape of services of local health contracts.Written in 1987 (well before the Affordable Health Care Act of 2010 changed the healthcare landscape considerably), this report is a bit antiquated, but still useful for its exploration of an age-old dynamic (is healthcare best delivered through the public, private or non-profit sectors?) that remains relevant. Furthermore, many of the considerations that governments must consider when awarding health contracts (cost, quality, honestly, ethics, constituency preferences, etc) still hold true today.