Reiser S J
Program on Humanities and Technology in Health Care, The University of Texas Health Science Center, Houston 77225.
JAMA. 1992 Mar 18;267(11):1511-5.
This report examines the role of the expert in the American health care system, both as provider and administrative policymaker. It shows that the guiding assumption of American health care policy, ie, that the medical system can and should be managed by experts on behalf of consumers and patients, does not hold up to scrutiny. It also demonstrates that the important theme in American history of placing authority and responsibility for action in the hands of the individual has not been sufficiently influential in American health care. Drawing on this theme and creating consumer competence and responsibility in health care choices as the keys to health care reform in the United States are advocated.
本报告审视了专家在美国医疗体系中作为医疗服务提供者和行政政策制定者所扮演的角色。报告表明，美国医疗政策的指导性假设，即医疗体系能够且应该由专家代表消费者和患者进行管理，经不住仔细推敲。报告还表明，美国历史上将行动的权力和责任赋予个人这一重要主题，在美国医疗领域并未产生足够大的影响。有人主张借鉴这一主题，培养消费者在医疗保健选择方面的能力和责任感，将其作为美国医疗改革的关键。
