Higgins W
Health Service Administration Western Kentucky University.
Health Care Manage Rev. 1991 Winter;16(1):65-72.
During the 1980s, private economists and government policy-makers promoted market competition as a means of controlling costs and improving quality in the health services industry. However, inflation-adjusted costs rose faster during the 1980s than during the 1970s, and most of the expected benefits were not realized. Competitive reform failed because government and private payors were unwilling or unable to force providers to compete primarily on price and quality. Despite its failure to control costs, competitive reform has created a "mythology" that continues to influence health policy to the detriment of effective reform.
在20世纪80年代，私营经济学家和政府政策制定者将市场竞争作为控制医疗服务行业成本和提高质量的一种手段加以推行。然而，经通胀调整后的成本在20世纪80年代的上涨速度比20世纪70年代更快，而且大部分预期效益并未实现。竞争性改革失败了，因为政府和私人付款方不愿或无法迫使医疗服务提供者主要在价格和质量方面展开竞争。尽管未能控制成本，但竞争性改革制造了一种“神话”，这种“神话”继续影响着卫生政策，对有效改革造成损害。
