Mayer J D
Soc Sci Med. 1986;23(10):1059-65. doi: 10.1016/0277-9536(86)90264-9.
The American health care system is confronting a crisis: one consisting of severe problems of cost and access, and the other consisting of significant qualitative changes in structure, systemic behavior and operation. Some of these factors may be understood better in comparison with how systems in other nations have responded to similar problems. The United States had adopted solutions which are significantly different from those of other countries, including more limited government involvement in health care and planning, and the development of corporatized medicine. These solutions pose significant ethical and operational problems.
一方面存在成本和可及性方面的严重问题,另一方面在结构、系统行为和运作方面发生了重大质性变化。与其他国家的医疗系统应对类似问题的方式相比,其中一些因素可能会得到更好的理解。美国采取的解决方案与其他国家的显著不同,包括政府在医疗保健和规划方面的参与更为有限,以及发展商业化医疗。这些解决方案带来了重大的伦理和运作问题。