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利润的暴政:财富集中、企业全球化与失败的美国医疗体系。

The tyranny of profit: concentration of wealth, corporate globalization, and the failed US health care system.

作者信息

Schroeder Carole

机构信息

University of Washington School of Nursing, Seattle, Wash, USA.

出版信息

ANS Adv Nurs Sci. 2003 Jul-Sep;26(3):173-84. doi: 10.1097/00012272-200307000-00003.

Abstract

In this article, I argue that the concentration of wealth and power in the United States and its accompanying ideals of corporate capitalism and globalization are destroying not only the economic security of US families, but also our health care system and the ideals of a participatory democracy. The article is composed of 2 parts. Part I is a portrayal of the US economic and health care system as it is, one that enacts an ideology of never-ending profit, inequality, and exclusion based on class, color, and ability to pay. Initially, I outline the wealth gap in our society and deconstruct the popular myth that most US families benefited from the stock market gains of the 80s and 90s; next I discuss the process of corporatization and globalization of business and the resultant attack on the ideals of participatory democracy. Finally, I briefly trace the history of the corporatization of US health care and outline its impact on costs, access, quality, and population health. Part II is a more philosophical discussion of ways out of the dilemmas portrayed in Part I. Among other things, I discuss how a deepening of our political commitment is needed, a process that entails a move away from the current politics of the Prince toward a politics of the people. This deeper way of living our politics makes every act a political act, enabling us to resist what we are told, denounce that which is unacceptable, unite around common ground, and enact previously unimagined alternatives.

摘要

在本文中,我认为美国财富和权力的集中以及与之相伴的企业资本主义和全球化理念,不仅正在破坏美国家庭的经济安全,还在损害我们的医疗保健系统以及参与式民主的理想。本文由两部分组成。第一部分描绘了美国当前的经济和医疗保健系统,它践行着一种基于阶级、肤色和支付能力的永无止境的利润、不平等和排斥的意识形态。首先,我概述了我们社会中的贫富差距,并解构了一个流行的神话,即大多数美国家庭从80年代和90年代的股市收益中受益;接下来,我讨论了企业的公司化和全球化进程以及由此对参与式民主理想的攻击。最后,我简要追溯了美国医疗保健公司化的历史,并概述了其对成本、可及性、质量和人群健康的影响。第二部分是对摆脱第一部分所描绘困境的方法进行更具哲学性的讨论。其中,我讨论了如何需要深化我们的政治承诺,这一过程需要从当前的王子式政治转向人民政治。这种更深层次的政治生活方式使每一个行为都成为一种政治行为,使我们能够抵制别人告诉我们的东西,谴责不可接受的事物,围绕共同点团结起来,并制定以前无法想象的替代方案。

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