de Pouvourville G, Renaud M
Soc Sci Med. 1985;20(2):153-66. doi: 10.1016/0277-9536(85)90300-4.
Since the mid-1960s, France and Canada have developed different ways of managing their hospital systems. In Canada, each provincial government has gradually imposed technocratic control with the aim of planning the allocation of health-care resources. In spite of attempts to do the same in France, the hospital system has grown with few restrictions other than those set by the medical profession itself. Consequently, health expenditures have risen at one of the fastest paces in Europe. The provincial monopoly over hospital care in Canada contrasts with the juxtaposition of local 'cartels' throughout France resulting, for the latter, in a much more uncoordinated system. After a description of each country's hospital system and its historical origins, the advantages and disadvantages of each system are assessed so as to understand current public debate in each country.
自20世纪60年代中期以来，法国和加拿大发展出了不同的医院系统管理方式。在加拿大，每个省政府逐渐实施技术官僚控制，旨在规划医疗保健资源的分配。尽管法国也曾试图这样做，但医院系统的发展几乎没有受到除医疗行业自身设定的限制以外的其他限制。因此，医疗支出以欧洲最快的速度之一增长。加拿大省级对医院护理的垄断与法国各地地方“卡特尔”的并存形成对比，这导致法国的系统更加缺乏协调性。在描述了每个国家的医院系统及其历史渊源之后，对每个系统的优缺点进行了评估，以便了解每个国家当前的公众辩论。
