Enthoven Alain C
Graduate School of Business, Stanford University, Stanford, California, USA.
Health Aff (Millwood). 2004 Mar-Apr;23(2):25-7. doi: 10.1377/hlthaff.23.2.25.
The "market forces" to which economists ascribe the ability to motivate improvement in quality and efficiency are largely nonexistent in U.S. health care. One thus might ask, "Could market forces be made strong enough to deliver efficient health care systems?" There is some evidence to suggest that the answer is "Yes." This paper offers a short list of some changes that would be needed to create such a health care economy. Continued increases in costs and in the numbers of uninsured people will likely make a universal coverage model based on Medicare a politically popular choice, but such a model would not deliver efficient health care systems because it lacks sufficient incentives for consumers to choose less costly options.
经济学家认为能够推动质量和效率提升的“市场力量”在美国医疗保健领域基本不存在。因此有人可能会问：“能否让市场力量强大到足以提供高效的医疗保健体系？”有证据表明答案是“可以”。本文简要列出了建立这样一种医疗保健经济所需的一些变革。成本的持续上升以及未参保人数的增加可能会使基于医疗保险的全民覆盖模式成为政治上受欢迎的选择，但这种模式无法提供高效的医疗保健体系，因为它缺乏足够的激励措施促使消费者选择成本较低的方案。
