Waitzkin H, Iriart C
Division of Community Medicine, University of New Mexico, Albuquerque 87131, USA.
Int J Health Serv. 2001;31(3):495-505. doi: 10.2190/BQDD-59K2-3PQD-RE9Q.
As their expansion slows in the United States, managed care organizations will continue to enter new markets abroad. Investors view the opening of managed care in Latin America as a lucrative business opportunity. As public-sector services and social security funds are cut back, privatized, and reorganized under managed care, with the support of international lending agencies such as the World Bank, the effects of these reforms on access to preventive and curative services will hold great importance throughout the developing world. Many groups in Latin America are working on alternative projects that defend health as a public good, and similar movements have begun in Africa and Asia. Increasingly, this organizing is being recognized not only as part of a class struggle but also as part of a struggle against economic imperialism--which has now taken on the new appearance of rescuing less developed countries from rising health care costs and inefficient bureaucracies through the imposition of neoliberal managed-care solutions exported from the United States.
随着美国市场扩张放缓，管理式医疗组织将继续进军海外新市场。投资者认为拉丁美洲管理式医疗市场的开放是一个利润丰厚的商业机会。在世界银行等国际贷款机构的支持下，随着公共部门服务和社会保障基金被削减、私有化并在管理式医疗框架下进行重组，这些改革对预防和治疗服务可及性的影响在整个发展中世界都将至关重要。拉丁美洲的许多团体正在开展将健康视为公共利益的替代项目，非洲和亚洲也已开始出现类似运动。这种组织行动越来越被视为不仅是阶级斗争的一部分，也是反对经济帝国主义斗争的一部分——经济帝国主义如今呈现出新的面貌，即通过推行从美国输出的新自由主义管理式医疗解决方案，将欠发达国家从不断上涨的医疗成本和低效官僚机构中解救出来。
