Blake C H, Adolino J R
James Madison University, Harrisonburg, Virginia, USA.
J Health Polit Policy Law. 2001 Aug;26(4):679-708. doi: 10.1215/03616878-26-4-679.
The scholarly literature on health care politics has generated a series of hypotheses to explain U.S. exceptionalism in health policy and to explain the adoption of national health insurance (NHI) more generally. Various cultural, institutional, and political conditions are held to make the establishment of some form of national health insurance policy more (or less) likely to occur. The literature is dominated by national and comparative case studies that illustrate the theoretical logic of these hypotheses but do not provide a framework for examining the hypotheses cross-nationally. This article is an initial attempt to address that void by using Boolean analysis to examine systematically several of the major propositions that emerge from the case study literature on the larger universe of twenty advanced industrial democracies. This comparative analysis offers considerable support for the veto points hypothesis while still finding each of the factors examined to be relevant in certain scenarios. We conclude with a discussion of the implications of these findings for future research and for advocates of national health insurance in the United States.
关于医疗保健政治的学术文献提出了一系列假设，以解释美国在卫生政策方面的特殊性，并更广泛地解释国家医疗保险（NHI）的采用情况。各种文化、制度和政治条件被认为会使某种形式的国家医疗保险政策的建立更有可能（或更不可能）发生。该文献主要是国家和比较案例研究，这些研究说明了这些假设的理论逻辑，但没有提供一个跨国检验这些假设的框架。本文首次尝试通过布尔分析来填补这一空白，系统地检验从关于20个先进工业民主国家这一更大范围的案例研究文献中得出的几个主要命题。这种比较分析为否决点假设提供了相当大的支持，同时仍发现所研究的每个因素在某些情况下都是相关的。我们最后讨论了这些发现对未来研究以及对美国国家医疗保险倡导者的意义。
