Spitz B, Abramson J
Brandeis University.
Milbank Q. 1987;65(3):348-70.
Political support for competition, capitation, and case management in health services has come from successive Congresses and presidents. Benefits attributed to these organizational/financing strategies are consistent with society's preference for a private market approach. Yet, the promise has not been pursued in effective public policy or program. The systemic barriers to implementation of alternative delivery systems are examined in the context of Medicaid; they are neither trivial nor intractable.
历届国会和总统都对医疗服务中的竞争、按人头付费和病例管理给予了政治支持。这些组织/融资策略所带来的好处与社会对私人市场方法的偏好是一致的。然而，这一承诺尚未在有效的公共政策或项目中得到落实。在医疗补助计划的背景下，研究了替代服务体系实施过程中的系统性障碍；这些障碍既非微不足道，也非难以解决。
