Blendon R J
N Engl J Med. 1979 Jun 28;300(26):1453-8. doi: 10.1056/NEJM197906283002603.
China's economic policies of the past 25 years have shaped its present health-care system. China's leadership has decided to have neither a national health-insurance system nor a national health service. Instead, it decided that its health system would mirror the workings of its industrial and agricultural system. Decisions to minimize imports, ban private economic activity, assign university graduates on a compulsory basis, control wages, maintain a large domestic standing army and prevent professions or universities from acquiring independent status led directly to the present system of medical care. Consequently, transplantation of China's striking achievements in health-care delivery to the United States or other countries is unlikely to occur in the absence of transfer of the underlying economic policies.
中国过去25年的经济政策塑造了其当前的医疗体系。中国领导层决定既不建立国家医疗保险体系,也不实行国家医疗服务制度。相反,它决定其医疗体系将效仿其工农业体系的运作方式。减少进口、禁止私营经济活动、强制分配大学毕业生、控制工资、维持庞大的国内常备军队以及阻止专业或大学获得独立地位的决策直接导致了当前的医疗体系。因此,在不转移相关经济政策的情况下,将中国在医疗服务方面取得的显著成就移植到美国或其他国家不太可能实现。