Jacobson P D
RAND, Santa Monica, CA 90407, USA.
Health Care Financ Rev. 1995 Spring;16(3):177-96.
In 1993, Washington State enacted the Health Services Act of 1993 (HSA) to guarantee universal access to health care through an employer mandate, with caps on premiums as the primary cost-control mechanism. The HSA represents the Nation's first formal experiment with managed competition. This article reports the results of a case study of the HSA's implementation. The study concludes that the Washington State initiative can be replicated in other States, but that implementation is complex, requires sustained public education, and requires cooperation from the Federal Government through program waivers. A major implementation challenge is to facilitate competition and minimize regulation.
1993年，华盛顿州颁布了《1993年卫生服务法案》（HSA），通过雇主强制参保来确保全民享有医疗保健服务，并将保费上限作为主要的成本控制机制。HSA是美国首次进行的管理式竞争正式试验。本文报告了对HSA实施情况的一项案例研究结果。该研究得出结论，华盛顿州的这一举措可在其他州推广，但实施过程复杂，需要持续的公众教育，且需要联邦政府通过项目豁免予以合作。一个主要的实施挑战是促进竞争并尽量减少监管。
