Fein R
J Public Health Policy. 1990 Spring;11(1):49-61.
This paper examines the expansion of for-profit health care organizations, focusing on hospitals. It argues that much of the support of for-profits derives from American market ideology and the assumption that the search for profits leads to efficiency in production. In the health field, there is no evidence, however, that such gains in efficiency exist or that, if they do, they are shared with patients in the form of lower costs of care or with employees in the form of higher wages. The paper presents a number of reasons for concluding that for-profits would not serve the needs of patients, care deliverers, local communities, or the health care system. Potential efficiency gains, even if realized, would be far outweighed by the damage that for-profits would cause.
本文考察了营利性医疗保健机构的扩张情况，重点关注医院。文章认为，对营利性机构的诸多支持源自美国的市场意识形态以及一种假设，即追求利润会带来生产效率。然而，在医疗领域，并无证据表明存在这种效率提升，或者即便存在，也没有以降低医疗成本的形式让患者受益，或以提高工资的形式让员工受益。本文提出了若干理由，以说明营利性机构无法满足患者、医疗服务提供者、当地社区或医疗保健系统的需求。即便实现了潜在的效率提升，营利性机构造成的损害也会远远超过这些收益。
