Socolar D, Sager A, Hiam P
Access and Affordability Monitoring Project, Boston University School of Public Health.
J Am Health Policy. 1992 Mar-Apr;2(2):45-50.
Competition in California has cost lives and money. Shifting care out of hospitals reduced hospital spending relative to other states, but overall health spending per capita rose to the second highest in the nation in 1990. High spending coexists with low rates of coverage--the state ranks seventh in percentage of people lacking insurance. Hospitals have closed emergency rooms and other unprofitable services while marketing duplicative and often unnecessary services to the well-insured. With real free markets unattainable in health care, California's competitive rhetoric has rationalized growing inequalities and higher costs. The market's invisible hand has picked Californians' pockets and endangered both rich and poor.
加利福尼亚州的竞争已让生命和金钱付出代价。与其他州相比，将医疗护理从医院转移出去降低了医院开支，但1990年人均医疗总支出升至全国第二高。高支出与低覆盖率并存——该州在未参保人口比例方面排名第七。医院关闭了急诊室和其他无利可图的服务科室，同时却向医保充足的人群推销重复且往往不必要的服务。由于在医疗保健领域无法实现真正的自由市场，加利福尼亚州有关竞争的言辞为日益加剧的不平等和更高的成本提供了合理化依据。市场这只“看不见的手”掏了加利福尼亚州民众的腰包，危及了富人和穷人的利益。
