Stevenson G
Int J Health Serv. 1978;8(1):41-54. doi: 10.2190/DAC5-TPV6-XUHL-CRMV.
The U.S. health care industry is composed of a dynamic mixture of profit and non-profit entities. These sectors sometimes compete in the same activities and may have virtual monopolies over other activities. Estimates of the relative and absolute sizes and growth trends of the profit and non-profit sectors are developed in this article. These estimates show that approximately 39 percent of total health care expenditures in the U.S. in 1975 went to for-profit institutions, generating $3.3 billion in profit. This represented 7 percent of for-profit and 2.8 percent of total expenditures. Some for-profit subsectors grew more rapidly and others less rapidly than total health care expenditures. As a whole, the for-profit sector grew faster than the non-profit sector before and after Medicare and Medicaid were introduced as well as during the period when price controls were in effect. The relative growth of the for-profit sector was greatest right after the introduction of Medicare and Medicaid. The true significance of profit lies not in numbers, but in the effects that the drive for profit have on the nature and quality of health and health care. This is discussed in the final section.
美国医疗保健行业由盈利性和非营利性实体动态混合组成。这些部门有时在相同活动中竞争，并且可能在其他活动中拥有事实上的垄断地位。本文对盈利性和非营利性部门的相对规模与绝对规模以及增长趋势进行了估算。这些估算表明，1975年美国医疗保健总支出中约39%流向了盈利性机构，产生了33亿美元的利润。这占盈利性机构支出的7%，占总支出的2.8%。一些盈利性子部门的增长速度比医疗保健总支出更快，而另一些则较慢。总体而言，在医疗保险和医疗补助计划推出之前和之后，以及在实施价格管制期间，盈利性部门的增长速度都快于非营利性部门。盈利性部门的相对增长在医疗保险和医疗补助计划推出后最为显著。利润的真正意义不在于数字，而在于对健康及医疗保健的性质和质量产生的影响。这将在最后一部分进行讨论。
