Department of Gerontology, Gerontology Institute, University of Massachusetts Boston, Boston, Massachusetts 02125, USA.
J Aging Soc Policy. 2011 Jan;23(1):73-93. doi: 10.1080/08959420.2010.532016.
In 2009, as the United States moved toward health care reform, the government of Bermuda implemented its FutureCare program to make health care for seniors more affordable. This article investigates how preferences for reform and its eventual design were shaped by the country's social history and commitment to free market values. Data derive from 36 in-depth interviews with key stakeholders deemed knowledgeable about health care financing and delivery in Bermuda, including government officials, provider representatives, insurance executives, and consumer advocates. Data also derive from a variety of documentary sources. Results indicate that although a clear need for health care and the ability to finance it for seniors exists in Bermuda, the scope of reform was circumscribed by preferences for prior policy decisions, creating a favorable tax and business environment for international corporations and a minimalist social welfare state for addressing racial and economic inequality. This suggests that widespread agreement on the challenges in meeting the health and long-term care needs of the elderly does not necessarily lead to equally commensurable solutions to addressing it.
2009 年，美国推动医疗改革之际，百慕大政府实施了 FutureCare 计划，以降低老年人的医疗保健费用。本文研究了改革的偏好及其最终设计是如何受到该国社会历史和对自由市场价值观的承诺的影响。数据来自对 36 名关键利益相关者的深入访谈，这些利益相关者被认为对百慕大的医疗保健融资和提供方面有深入了解，包括政府官员、提供者代表、保险高管和消费者权益倡导者。数据还来自各种文献来源。结果表明，尽管百慕大老年人对医疗保健和为其提供资金的需求明显，但改革的范围受到先前政策决策偏好的限制，为国际公司创造了有利的税收和商业环境，并为解决种族和经济不平等问题建立了一个最小化的社会福利国家。这表明，尽管广泛认同满足老年人健康和长期护理需求所面临的挑战，但并不一定能找到同样相称的解决方案来应对这些挑战。
