Oliver Thomas R, Singer Rachel Friedman
Department of Health Policy and Management, Johns Hopkins University, Bloomberg School of Public Health, 624 N. Broadway, Room 403, Baltimore, MD 21205, USA.
Health Serv Res. 2006 Jun;41(3 Pt 2):1124-58. doi: 10.1111/j.1475-6773.2006.00523.x.
This article examines the role of the California Health Benefits Review Program (CHBRP) as a source of information in state health policy making. It explains why the California benefits review process relies heavily on university-based researchers and employs a broad set of criteria for review, which set it apart from similar programs in other states. It then analyzes the politics of health insurance mandates and how independent research and analysis might alter the perceived benefits and costs of health insurance mandates and thus political outcomes. It considers how research and analysis is typically used by policy makers, and illustrates how participants inside and outside of state government have used the reports prepared by CHBRP as both guidance in policy design and as political ammunition. Although there is consensus that the review process has reduced the number of mandate bills that are passed out of the legislature, both supporters and opponents favor the new process and generally believe the reports strengthen their case in legislative debates over health insurance mandates. The role of the CHBRP is narrowly defined by statute at the present time, but the program may well face pressure to evolve from its current academic orientation into a more interactive, advisory role for legislators in the future.
本文探讨了加利福尼亚州健康福利审查项目(CHBRP)作为该州健康政策制定信息来源的作用。文中解释了为何加利福尼亚州的福利审查过程严重依赖大学研究人员,且采用了一套广泛的审查标准,这使其有别于其他州的类似项目。接着,文章分析了医疗保险授权政策的政治因素,以及独立研究与分析如何可能改变人们对医疗保险授权政策的预期收益和成本,进而影响政治结果。文章考量了政策制定者通常如何运用研究与分析,并举例说明州政府内外的参与者如何将CHBRP编写的报告既用作政策设计的指导,又用作政治弹药。尽管人们一致认为审查过程减少了立法机构通过的授权法案数量,但支持者和反对者都支持这一新流程,并且普遍认为这些报告在关于医疗保险授权政策的立法辩论中强化了他们的论据。目前,CHBRP的作用在法规中被狭义定义,但该项目未来很可能面临压力,需要从当前的学术导向转变为对立法者更具互动性的咨询角色。