White K, Collyer F
Department of Sociology, Australian National University.
Aust Health Rev. 1997;20(2):13-25. doi: 10.1071/ah970013.
The Australian political arena echoes with calls for the privatisation of health care institutions, the contracting-out of health care services and the introduction of various marketing strategies into hospital management. These calls are justified by asserting that the market, rather than the public sector, can provide better services, greater productivity and increased efficiency. The National Health Strategy (1991, p 17) provides a good example. Noting that Australia is copying American investment trends for hospital 'chains' rather than for independent small establishments, the strategy dismisses any concern over changes in ownership, pointing instead to a 'process of rationalisation' that is to be 'welcomed'. Using evidence from the United States, United Kingdom and Australian hospital sectors, this paper examines claims for the greater efficiency of market processes.
澳大利亚政治舞台上回响着要求医疗机构私有化、医疗服务外包以及在医院管理中引入各种营销策略的呼声。这些呼声的理由是,市场而非公共部门能够提供更好的服务、更高的生产率和更高的效率。《国家卫生战略》(1991年,第17页)就是一个很好的例子。该战略指出,澳大利亚正在效仿美国对医院“连锁机构”而非独立小机构的投资趋势,它对所有权的变化毫不担忧,反而指出这是一个应“受到欢迎”的“合理化进程”。本文利用来自美国、英国和澳大利亚医院部门的证据,审视了有关市场进程效率更高的说法。