Mueller K J
J Health Polit Policy Law. 1986 Spring;11(1):117-35. doi: 10.1215/03616878-11-1-117.
This paper analyzes nine health policy votes in the U.S. House of Representatives. The votes all occurred between 1973 and 1980 and include such issues as health planning, health maintenance organizations, cost containment, and professional standards review organizations. The objective of this analysis is to examine the independent contribution of variables indigenous to health issues while controlling for party identification and ideology. The influence of health providers, measured by the effect of the number of state medical association members in each state, is significant in the findings. The state and local share of Medicaid expenses is also significant in explaining several votes. Contributions from political action committees were not important until 1979, when the rising costs of campaigns gave them more influence, and when our measures of their influence improved. By the time Congress voted in 1979 on hospital cost containment legislation, the PAC variable surpassed even the AMA variable in importance.
本文分析了美国众议院的九次卫生政策投票。这些投票均发生在1973年至1980年之间,涉及卫生规划、健康维护组织、成本控制以及专业标准审查组织等问题。本分析的目的是在控制党派认同和意识形态的同时,研究卫生问题固有变量的独立贡献。研究结果表明,以各州医学协会会员数量的影响来衡量的医疗服务提供者的影响力显著。医疗补助费用的州和地方份额在解释几次投票结果时也具有显著意义。直到1979年,政治行动委员会的捐款才变得重要起来,当时竞选成本不断上升,使它们有了更大影响力,而且我们对其影响力的衡量方法也有所改进。到1979年国会就医院成本控制立法进行投票时,政治行动委员会这一变量的重要性甚至超过了美国医学协会这一变量。