Steffen M
CERAT, Institut d'Etudes Politiques, Université des Sciences Sociales de Grenoble, Saint Martin d'Hères, France.
Int J Health Serv. 1989;19(4):651-61. doi: 10.2190/36GG-T0YV-X7Q5-W7TJ.
The author presents the main features of the organization of the French health care system, revealing an important mixture of public and private actors and institutions and a large number of political restraints that oppose resistance to privatization. In spite of traditional references to "liberal medicine" and recurrent debates opposing public and private intervention, neither the doctors nor the political decision makers have really supported the few projects that have been proposed for privatization or liberalization of health care. On the contrary, the cost-control policy introduced growing State intervention and new management methods into the health care sector, whose actors were not used to it. The privatization and liberalization debates appear as a rhetoric necessary to accommodate these difficult changes.
作者介绍了法国医疗体系组织的主要特征,揭示了公共和私人行为体及机构的重要混合,以及大量反对医疗私有化阻力的政治限制。尽管传统上提及“自由医学”,且公共和私人干预的辩论反复出现,但医生和政治决策者都没有真正支持过为医疗私有化或自由化提出的少数项目。相反,成本控制政策将越来越多的国家干预和新的管理方法引入了医疗领域,而该领域的行为体对此并不习惯。私有化和自由化辩论似乎是适应这些艰难变革所必需的一种说辞。