Population Health Sciences Institute, 5994Newcastle University, Newcastle upon Tyne, UK.
Int J Health Serv. 2022 Oct;52(4):470-479. doi: 10.1177/00207314221114540. Epub 2022 Jul 25.
The National Health Service was established in the United Kingdom in 1948 as a universal, comprehensive service free at the point of delivery, which is publicly provided, funded, and accountable. Market incrementalism in England has eroded this system over three decades. The recently enacted Health and Care Act will erode it further. This article first explains briefly how legislation and policy initiatives in 1990, 2003, and 2012 furthered development of the market and private provision of health services, and then describes the main structural changes in the new Act and their implications. England is now moving decisively toward a marketized, two-tier, mixed-funding system with several similarities to the United States.
英国国民医疗服务体系于 1948 年成立，是一种普及、全面、免费的服务，由公共资金提供并负责。三十年来，英国市场的增量主义逐渐侵蚀了这一体系。最近颁布的《健康与保健法案》将进一步削弱这一体系。本文首先简要解释了 1990 年、2003 年和 2012 年的立法和政策举措如何进一步推动了市场和私营医疗服务的发展，然后描述了新法案的主要结构变化及其影响。英国现在正果断地朝着市场化、双层、混合筹资体系迈进，与美国有几个相似之处。
