Center for Health Policy Research and Ethics at George Mason University, Fairfax, Virginia, USA.
Health Aff (Millwood). 2010 Jun;29(6):1152-7. doi: 10.1377/hlthaff.2010.0444.
Lost in the rhetoric about the supposed government takeover of health care is an appreciation of the inherently federalist approach of the Patient Protection and Affordable Care Act. This federalist tradition, particularly with regard to health insurance, has a history that dates back at least to the 1940s. The new legislation broadens federal power and oversight considerably, but it also vests considerable new powers and responsibilities in the states. The precedents and examples it follows will guide federal and state policy makers, stakeholders, and ordinary citizens as they breathe life into the new law. The challenges ahead are formidable, and the greatest ones are likely to be political.
在关于政府接管医疗保健的言论中，人们忽略了《患者保护与平价医疗法案》（Patient Protection and Affordable Care Act）固有的联邦制方法。这种联邦制传统，尤其是在医疗保险方面，可以追溯到至少 20 世纪 40 年代。新立法大大扩大了联邦权力和监督范围，但也赋予了各州相当多的新权力和责任。它所遵循的先例和范例将指导联邦和州政策制定者、利益相关者以及普通公民在为新法律注入生命力时做出决策。未来的挑战是巨大的，最大的挑战可能是政治方面的。
