Navarro V
Int J Health Serv. 1983;13(1):169-74. doi: 10.2190/BNLU-QHFE-VJMN-88KT.
Current federal policies include substantial cuts in government expenditures for health programs and for care of the poor, elderly, and handicapped, and the weakening of government regulations in health and medical care. These policies are presented by many political, academic, and medical leaders as responding to a popular mandate both to cut government expenditures in all non-military areas and to diminish government intervention in health care and medicine. Also, it is assumed that the tax revolt that occurred in the late seventies further triggered the need for tax cuts and cuts in all social expenditures, including health and educational expenditures. The evidence of North American people's wants, wishes, and desires--measured by leading polls--leads to opposite conclusions, however. In the period 1977-1982, there has been continuous popular support of government programs for health and education; for care of the elderly, poor, and handicapped; and for strengthening government regulations in health care and medicine. During these years, there has been a popular mandate not to decrease but, rather, to increase such interventions. Thus, the current policies cannot be presented as responding to a popular mandate. In fact, the mandate is for policies precisely opposite to the ones which are being implemented by the Reagan Administration.
当前的联邦政策包括大幅削减政府用于卫生项目以及照顾穷人、老年人和残疾人的支出，同时削弱政府对医疗卫生保健的监管。许多政治、学术和医学领袖认为，这些政策是对一项民众授权的回应，即既要削减所有非军事领域的政府开支，又要减少政府对医疗卫生保健的干预。此外，人们认为七十年代末发生的抗税事件进一步引发了减税以及削减包括医疗卫生和教育支出在内的所有社会支出的需求。然而，通过主要民意调查衡量得出的北美民众的需求、愿望和期望的证据却得出了相反的结论。在1977年至1982年期间，民众一直支持政府的医疗卫生和教育项目；支持照顾老年人、穷人及残疾人；支持加强政府对医疗卫生保健的监管。在这些年里，民众的授权是不要减少，而是要增加此类干预。因此，当前的政策不能被视为对民众授权的回应。事实上，民众所要求的政策恰恰与里根政府正在实施的政策相反。
