Altman D
J Health Polit Policy Law. 1978 Winter;2(4):560-80. doi: 10.1215/03616878-2-4-560.
This paper examines the political and bureautic dynamics of health regulation under the National Health Planning and Resources Development Act and, to a lesser extent, the Carter Cost Proposal now before Congress. A number of underlying issues that affect the day-to-day exercise of health planning are considered, including the contest between state and local and federal government for program control, jurisdictional conflict between state and local planning agencies, and the unsettled roles to be played by professional planners, consumers, and providers. When we assess regulatory policy in health, these complicating factors must be added to the long list of handicaps that already exist. One important finding is that local planning agencies have embraced the task of health regulation somewhat more fully than had generally been expected. A number of explanations for this are offered. In short, the controlling factors in health planning are political, not technical, and there is more occurring at the state and local levels than many had predicted, although any impact is not likely to be dramatic.
本文研究了《国家卫生规划与资源开发法案》下卫生监管的政治和官僚动态，在较小程度上也研究了目前提交给国会的卡特成本提案。文中考虑了一些影响卫生规划日常实施的潜在问题，包括州和地方政府与联邦政府之间对项目控制权的争夺、州和地方规划机构之间的管辖权冲突，以及专业规划人员、消费者和提供者有待明确的角色。当我们评估卫生监管政策时，这些复杂因素必须添加到已存在的一长串障碍之中。一个重要发现是，地方规划机构对卫生监管任务的接受程度比普遍预期的要高一些。文中对此提供了一些解释。简而言之，卫生规划中的控制因素是政治性的，而非技术性的，州和地方层面发生的事情比许多人预测的要多，尽管任何影响可能都不会很显著。
