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美国的痼疾:健康政策中的市场信仰者:评“论卫生政策与管理(HPAM):关注理论-政策-实践差距”。

An American plague: Pro-market believers in health policy: Comment on "On Health Policy and Management (HPAM): mind the theory-policy-practice gap".

机构信息

Conservatoire National des Arts et Métiers, Paris, France.

出版信息

Int J Health Policy Manag. 2015 Jan 22;4(2):107-9. doi: 10.15171/ijhpm.2015.15. eCollection 2015 Feb.

Abstract

Although American health policy debates address similar problems to other developed nations, it has factual and ideological specificities. I agree with Chinitz and Rodwin on the dominance of micro-economics thinking. However, I am not certain that learning from management theory or modifying medical education will be powerful enough to change the system. The vested interests of the stakeholders are too powerful, the more so when they are supported by economists who ideologically reinforce them and by neglecting the fact that the basic premises of market ideology are false when applied to medical care. There is enough empirical evidence to support that but, apparently, these facts do not dent these beliefs.

摘要

尽管美国的卫生政策辩论涉及到与其他发达国家类似的问题,但它具有事实和意识形态上的特殊性。我同意 Chinitz 和 Rodwin 关于微观经济学思维主导地位的观点。然而,我不确定从管理理论中学习或修改医学教育是否有足够的力量来改变这个体系。利益相关者的既得利益太强大了,尤其是当他们得到那些在意识形态上支持他们的经济学家的支持时,而且忽视了这样一个事实,即当市场意识形态的基本前提应用于医疗保健时,它们是错误的。有足够的经验证据来支持这一点,但显然,这些事实并没有削弱这些信念。

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