Newman R, Hiatt D, Hargrave G E, Kilguss A F, Boress L S
Behav Healthc Tomorrow. 1997 Jun;6(3):48-53.
Market-driven, for-profit behavioral health systems put patients and investors in the same financial equation. Do shareholder profits depend on preventing patients from receiving appropriate care? Does investor greed directly increase consumer pain and suffering? Or, does the marketplace work the way one hopes: providing profits to investors in proportion to improvements in healthcare quality and affordability? Well-intentioned providers find themselves walking right through the middle of this high-stakes minefield. Should the government and the marketplace allow clinicians--and their standards of ethics and social values--to be swept away in the name of efficiency? Or does the marketplace for behavioral healthcare require government intervention through legislation and regulation to protect the interests of both patients and providers? This debate is far from over. Every reader of this journal has a vital stake in the outcome. In the following dialogue, leaders representing employers, clinicians, and managed care plans argue different positions in this debate and propose compelling solutions.
市场驱动的营利性行为健康系统将患者和投资者置于同一财务等式中。股东利润是否依赖于阻止患者获得适当的治疗？投资者的贪婪是否会直接加剧消费者的痛苦？或者，市场是否如人们所期望的那样运作：根据医疗质量和可负担性的提高按比例向投资者提供利润？善意的提供者发现自己正置身于这个高风险的雷区之中。政府和市场是否应该允许临床医生以及他们的道德和社会价值观标准以效率之名被扫除？或者行为健康护理市场是否需要政府通过立法和监管进行干预，以保护患者和提供者的利益？这场辩论远未结束。本杂志的每一位读者都与结果息息相关。在接下来的对话中，代表雇主、临床医生和管理式医疗计划的领导者们在这场辩论中阐述了不同的立场，并提出了令人信服的解决方案。
