Udvarhelyi I S, Relman A S, Binder G M, Spence R K, Kennedy E M, Grossman J H, Termeer H A, Raines L J, Marincola E, Pyle T O
Prudential Insurance Company of America, Philadelphia, PA.
Harv Bus Rev. 1994 Sep-Oct;72(5):45-7, 50, 52 passim.
In "Making Competition in Health Care Work" (July-August 1994), Elizabeth Olmsted Teisberg, Michael E. Porter, and Gregory B. Brown ask a question that has been absent from the national debate on health care reform: How can the United States achieve sustained cost reductions while at the same time maintaining quality of care? The authors argue that innovation driven by rigorous competition is the key to successful reform. A lasting cure for health care in the United States should include four basic elements: corrected incentives to spur productive competition, universal insurance to secure economic efficiency, relevant information to ensure meaningful choice, and innovation to guarantee dynamic improvement. In this issue's Perspectives section, eleven experts examine the current state of the health care system and offer their views on the shape that reform should take. Some excerpts: "On the road to innovation, let us not forget to develop the tools that allow physicians, payers, and patients to make better decisions." I. Steven Udvarhelyi; "Health care is not a product or service that can be standardized, packaged, marketed, or adequately judged by consumers according to quality and price." Arnold S. Relman; "Just as antitrust laws are the wise restraints that make competition free in other sectors of the economy, so the right kind of managed competition can work well in health care." Edward M. Kennedy "Biomedical research should be considered primarily an investment in the national economic well-being with additional humanitarian benefits." Elizabeth Marincola.
在《让医疗保健领域的竞争发挥作用》（1994年7 - 8月）一文中，伊丽莎白·奥姆斯特德·泰斯伯格、迈克尔·E·波特和格雷戈里·B·布朗提出了一个在全国医疗保健改革辩论中一直缺失的问题：美国如何在实现持续成本降低的同时保持医疗质量？作者认为，由激烈竞争驱动的创新是成功改革的关键。美国医疗保健的持久解决方案应包括四个基本要素：纠正激励措施以刺激有效竞争、全民保险以确保经济效率、相关信息以确保有意义的选择以及创新以保证动态改进。在本期的“观点”部分，十一位专家审视了医疗保健系统的现状，并就改革应采取的形式发表了他们的看法。部分摘录如下：“在创新之路上，我们不要忘记开发工具，让医生、支付方和患者能够做出更好的决策。”I. 史蒂文·乌德瓦赫利；“医疗保健不是一种可以标准化、打包、营销或由消费者根据质量和价格进行充分评判的产品或服务。”阿诺德·S·雷尔曼；“正如反垄断法是使其他经济部门的竞争自由进行的明智约束一样，正确类型的管理式竞争在医疗保健领域也能发挥良好作用。”爱德华·M·肯尼迪；“生物医学研究应主要被视为对国家经济福祉的投资，并附带人道主义效益。”伊丽莎白·马里恩科拉。
