Pepper Institute on Aging and Public Policy, Florida State University, Tallahassee, FL 32306, USA.
J Health Soc Behav. 2010 Jun;51(2):125-36. doi: 10.1177/0022146510368931.
A central sociological premise is that health care systems are organizations that are embedded within larger institutions, which have been shaped by historical precedents and operate within a specific cultural context. Although bound by policy legacies, embedded constituencies, and path dependent processes, health care systems are not rigid, static, and impervious to change. The success of health care reform in 2010 has shown that existing regimes do have the capacity to respond to new needs in ways that transcend their institutional and ideological limits. For the United States the question is how health care reform will reconfigure the existing network of public and private benefits and the power relationships between the numerous constituencies surrounding them. This article considers how institutions, interest groups, and ideology have affected the organization of the health care system in the United States as well as in other nations. It then discusses issues for future research in the aftermath of the 2009-10 health care reform debate.
一个核心的社会学前提是，医疗保健系统是嵌入在更大的机构中的组织，这些机构受到历史先例的影响，并在特定的文化背景下运作。尽管受到政策遗产、嵌入式选区和路径依赖过程的限制，医疗保健系统并非僵化、静态的，也并非对变革无动于衷。2010 年医疗改革的成功表明，现有制度确实有能力以超越其制度和意识形态限制的方式来应对新的需求。对美国来说，问题是医疗改革将如何重新配置现有的公共和私人福利网络以及围绕它们的众多选区之间的权力关系。本文探讨了制度、利益集团和意识形态如何影响美国以及其他国家的医疗保健系统的组织。然后，它讨论了 2009-10 年医疗改革辩论之后未来研究的问题。
