Newton Lisa H
Bus Ethics Q. 2002 Oct;12(4):505-26.
It is not too early to suggest that the attempts to place medical cae in private hands (through group insurance arrangements) has not fulfilled its promise--or better, the promises that were made for it. Yet history has not been kind to plans to make government the single payer, and the laudable progress in medical technology has placed high-technology medical care beyond the reach of most private budgets. In this paper I suggest that the major problem of the U.S. health care system as presently conceived is a failure of legitimacy, and I put forward a proposal that purports to solve that problem. The proposal is to localize health care, on the model of a public school system, on the argument that such localization will answer most of the questions of legitimacy at the core of the private insurance imbroglio, provide a brake for medical costs, while preserving our ability to take advantage of the most advanced medical interventions. I present some initial arguments for the proposal, but await its proof in the dialogue emerging as the present insurance system collapses.
试图将医疗护理交由私人掌控（通过团体保险安排）并未兑现其承诺——或者更确切地说，并未兑现为之许下的诸多承诺。然而，历史对政府成为单一支付方的计划并不友好，而且医疗技术方面值得称赞的进步使得高科技医疗护理超出了大多数私人预算的承受范围。在本文中，我认为当前美国医疗保健系统的主要问题在于缺乏合法性，并且我提出了一项旨在解决该问题的提议。该提议是以公立学校系统为模式对医疗保健进行本地化，理由是这种本地化将解决私人保险纠葛核心的大部分合法性问题，为医疗成本提供一个刹车装置，同时保留我们利用最先进医疗干预措施的能力。我为该提议提出了一些初步论据，但在当前保险系统崩溃之际出现的对话中等待其得到验证。
