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医生的抵制与公共医疗保健的形成:20世纪60年代加拿大和比利时医生罢工的比较分析

Physician resistance and the forging of public healthcare: a comparative analysis of the doctors' strikes in Canada and Belgium in the 1960s.

作者信息

Marchildon Gregory P, Schrijvers Klaartje

机构信息

Canada Research Chair in Public Policy and Economic History, Johnson-Shoyama Graduate School of Public Policy, University of Regina, 110-12 Research Drive, Regina, Saskatchewan S4S0A2, Canada.

出版信息

Med Hist. 2011 Apr;55(2):203-22. doi: 10.1017/s0025727300005767.

Abstract

Organized medicine in a number of advanced industrial countries resisted the post-war trend toward more state involvement in the funding and organisation of medical care. While there were eight doctors' strikes during the peak of reform efforts in the 1960s, two of the most prolonged and bitter struggles took place in Canada and Belgium. This comparative analysis of the two strikes highlights the philosophy, motives, and strategies of organised medicine in resisting state-led reform efforts. Although historical and institutional contexts in the two countries differed, organised medicine in Canada and Belgium thought and responded in very similar ways to the perceived threat of medical insurance reform. While the perception of who won and who lost the respective doctors' strikes differed, the ultimate impact on the trajectory of public healthcare on the medical profession was remarkably similar. In both countries, the strike would have a long-standing impact on future reform efforts, particularly efforts to reform physician remuneration in order to facilitate more effective primary healthcare.

摘要

一些发达工业国家的组织化医学抵制了战后国家更多地参与医疗保健资金筹集和组织工作的趋势。在20世纪60年代改革努力的高峰期发生了八次医生罢工,其中两次持续时间最长、斗争最激烈的罢工分别发生在加拿大和比利时。对这两次罢工的比较分析突出了组织化医学在抵制国家主导的改革努力时的理念、动机和策略。尽管两国的历史和制度背景不同,但加拿大和比利时的组织化医学对医疗保险改革所察觉到的威胁的思考和反应方式非常相似。虽然对各自医生罢工中谁赢谁输的看法不同,但对医疗行业公共医疗保健轨迹的最终影响却非常相似。在这两个国家,罢工将对未来的改革努力产生长期影响,特别是在改革医生薪酬以促进更有效的初级医疗保健方面的努力。

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