The author is with the Department of Social Medicine, School of Medicine, and Department of Health Policy & Management, Gillings School of Global Public Health, University of North Carolina at Chapel Hill.
Am J Public Health. 2019 Nov;109(11):1497-1500. doi: 10.2105/AJPH.2019.305295. Epub 2019 Sep 19.
Recently there has been a surge in political attention to Medicare for all, the latest chapter in a long history of conflict over national health insurance in the United States. This essay places the current Medicare for all debate in historical perspective.My aim is to illuminate past struggles over single-payer reform, explore the genesis and evolution of Medicare, and analyze the implications for contemporary health politics of the public and private insurance arrangements developed by the United States over the past century.The history of US health reform provides critical lessons for understanding the enduring appeal of single-payer models as well as the formidable political obstacles to transforming Medicare for all from an aspiration into a legislative reality.
最近，全民医疗保险（Medicare for all）受到了政治上的高度关注，这是美国在国家医疗保险问题上长期冲突的最新篇章。本文从历史的角度来探讨当前的全民医疗保险辩论。我的目的是阐明过去对单一支付者改革的斗争，探讨医疗保险的起源和演变，并分析美国在过去一个世纪中发展的公共和私人保险安排对当代健康政治的影响。美国卫生改革的历史为理解单一支付者模式的持久吸引力以及将全民医疗保险从愿望转变为立法现实所面临的巨大政治障碍提供了重要的经验教训。
