Klein Rudolf
Honorary Professor,London School of Hygiene and Tropical Medicine,London,UK.
Health Econ Policy Law. 2019 Jan;14(1):1-10. doi: 10.1017/S1744133117000354. Epub 2018 Jan 8.
The paper analyses the achievements and problems stemming from Nye Bevan's model of a tax funded national health care system, on the assumption that only so could equity be achieved. The evidence shows that indeed the National Health Service (NHS) scores highly on equity, so vindicating Bevan's vision. The price paid is that fiscal crises are the norm for the NHS, with ever more centralisation, intensive regulation and performance management. Successive reorganisations represent attempts to square the circle - to combine the strengths of Bevan's model and those of a less hierarchic system - but have so far failed to deliver and can be expected to continue.
本文分析了奈伊·贝文提出的由税收资助的国家医疗保健系统模式所取得的成就和存在的问题，前提是只有这样才能实现公平。证据表明，国民医疗服务体系（NHS）在公平性方面得分很高，从而证明了贝文的设想是正确的。所付出的代价是财政危机成为国民医疗服务体系的常态，伴随着越来越多的中央集权、严格监管和绩效管理。 successive reorganisations represent attempts to square the circle - to combine the strengths of Bevan's model and those of a less hierarchic system - but have so far failed to deliver and can be expected to continue. 连续的重组试图做到两全其美——将贝文模式的优势与一个层级性较低的系统的优势结合起来——但迄今为止未能成功，而且预计还会继续下去。
