Casanova J E
Milwaukee County Medical Complex, WI.
Physician Exec. 1993 Mar-Apr;19(2):10-2.
The United States and the former Soviet Union have historically organized health care delivery systems according to totally different paradigms. These two divergent approaches have constituted a kind of natural experiment. At the present time, our systems may be becoming more alike, with the former Soviet system decentralizing and even experimenting with forms of medical insurance. Our system, on the other hand, has become much more regulated and, if some have their way, would become increasingly monopsonistic. At this critical point, it may be useful to learn from each other's experiences as we plan for the future.
美国和前苏联在历史上按照完全不同的模式组织医疗服务体系。这两种截然不同的方法构成了一种自然实验。目前,我们的体系可能正变得越来越相似,前苏联体系在进行权力下放,甚至尝试各种医疗保险形式。另一方面,我们的体系受到了更多监管,而且如果某些人如愿以偿的话,将会变得越来越具有买方垄断性。在这个关键点上,当我们规划未来时,相互借鉴对方的经验可能会有所帮助。