Norato J F
Pennsylvania State University, Middletown, USA.
J Health Hum Serv Adm. 1997 Winter;19(3):341-56.
U.S. health care spending consumed about 14% of the GDP in 1992 and current trends threaten to boost this figure to 18% by the year 2000 (CBO, 1992). Our health care delivery system needs an overhaul but there is evidently little consensus on what format a new system should follow. Persuasive befuddling, and frequently contradictory, suggestions have ranged from the federal government's active involvement in a single-payer national health care plan to enactment of a nationwide mandate compelling (taxing?) employers to provide a minimum health benefit package to all workers. There were two common objectives shared by the major, recently contending health care reform proposals: first, to provide universal access to health care with assurances that coverage is maintained when economic circumstances change or when someone experiences poor health; second, to stunt the growth rate of health care spending nationally. Single-payer alternatives, previously introduced by Congressman McDermott and others, would have required a heavy federal subsidy, regulation, and blocking directing each state to establish and administer a health care system covering its entire population. Currently, the single-payer system has become a fading contender in a dissolving list of health care reform options that previously included a new, widely publicized option embracing managed care and so-called "managed competition." Most recently, however, the single-payer proposals have apparently gone nowhere, seriously sustaining sound political defeat. Divergent views of proponents and detractors of a single-payer plan, its funding and operation, are presented. It has become extremely difficult to get Congress to advance any particular proposal because of dire, unsubstantiated socioeconomic impact hypothesizing and the unrestrained politicizing of the health policy formulation process. On February 10th, 1994, the prestigious American College of Surgeons literally stunned the national health care community by its surprise public declaration of conceptual support for the still highly controversial legislative health care reform long-shot, the Single Payer Health Plan (Mcllarth, 1994). As individual physicians weighed the contentious single-payer health care issue against alternatives (O'Heany and Berry, 1994), many health care provider groups even now remain adamantly opposed to a single-payer system (Mitka, 1994), not unexpectedly including the vocally conservative leadership of the American Medical Association (Culhane, 1994; Cotton, 1994). As spokesman for the American College of Surgeons (ACS). Chairman David Murray MD, indicated that the 60,000-member group acted out of frustration with current insurer-run managed care plans and a desire to bring out reforms that permit patients to choose the physician or surgeon. At the time, Murray emphasized that the college had not endorsed any specific single-payer bills that were pending then in Congress and had a number of significant differences with the former leading contenders which had been sponsored by Rep. Jim McDermott MD (D. Wash.) and Sen. Paul Wellstone (D. Minn) (Mcllarth, 1994). However, testifying subsequently before the House Committee on Education and Labor, Dr. Murray said that single-payer approaches probably present the best assurances that patients could seek care from any physician they choose and that single-payer approaches could probably be made more simple and administratively workable (Cotton, 1994). Again, that time, Dr. Murray expressed concern about the extensive power that would have been granted to health insurance purchasing under the now defunct Clinton administration's "managed competition" health care reform package, HR 3600 (Ibid.). These concerns were shared by others (Geisel, 1993; Wagner, 1993). (ABSTRACT TRUNCATED)
1992年,美国医疗保健支出约占国内生产总值的14%,当前的趋势有可能使这一数字到2000年升至18%(国会预算办公室,1992年)。我们的医疗保健服务体系需要彻底改革,但对于新体系应采用何种形式,显然几乎没有达成共识。从联邦政府积极参与单一支付者的国家医疗保健计划,到颁布全国性指令迫使(征税?)雇主为所有工人提供最低限度的健康福利套餐,各种有说服力但令人困惑且常常相互矛盾的建议层出不穷。最近主要的医疗保健改革提案有两个共同目标:第一,确保普遍获得医疗保健,并保证在经济状况变化或有人健康状况不佳时仍能维持保险覆盖;第二,抑制全国医疗保健支出的增长速度。众议员麦克德莫特等人先前提出的单一支付者方案,需要大量联邦补贴、监管,并指导每个州建立和管理覆盖其全体人口的医疗保健系统。目前,单一支付者体系在一系列逐渐减少的医疗保健改革选项中已成为一个逐渐式微的竞争者,这些选项之前还包括一个新的、广受宣传的包含管理式医疗和所谓“管理式竞争”的选项。然而,最近,单一支付者提案显然毫无进展,在政治上遭受了严重挫折。文中呈现了单一支付者计划的支持者和反对者在其资金和运营方面的不同观点。由于可怕且未经证实的社会经济影响假设以及医疗政策制定过程的无节制政治化,国会很难推进任何特定提案。1994年2月10日,颇具声望的美国外科医师学会出人意料地公开宣布在概念上支持仍然极具争议的立法性医疗保健改革长远目标——单一支付者医疗计划,这着实令全国医疗保健界震惊(麦卡勒思,1994年)。当个体医生权衡有争议的单一支付者医疗保健问题与其他选项时(奥黑尼和贝里,1994年),许多医疗保健提供者团体至今仍坚决反对单一支付者体系(米特卡,1994年),不出所料,其中包括美国医学协会直言保守的领导层(卡尔汉,1994年;科顿,1994年)。作为美国外科医师学会(ACS)的发言人,主席大卫·默里医学博士表示,这个拥有6万名成员的团体采取行动是因为对当前保险公司运营管理式医疗计划感到失望,并且希望推动改革,让患者能够选择医生或外科医生。当时,默里强调该学会尚未认可当时国会中悬而未决的任何具体单一支付者法案,并且与众议员吉姆·麦克德莫特医学博士(华盛顿州民主党人)和参议员保罗·韦尔斯通(明尼苏达州民主党人)先前提出的主要竞争者存在一些重大差异(麦卡勒思,1994年)。然而,默里博士后来在众议院教育与劳工委员会作证时表示,单一支付者方式可能最能保证患者可以选择任何医生就诊,并且单一支付者方式或许可以变得更简单且在行政上更可行(科顿,1994年)。当时,默里博士再次表达了对现已失效的克林顿政府“管理式竞争”医疗保健改革方案(HR 3600)赋予医疗保险购买的广泛权力的担忧(出处同上)。其他人也有这些担忧(盖泽尔,1993年;瓦格纳,1993年)。(摘要已截断)