Dunham A, Morone J A, White W
J Health Polit Policy Law. 1982 Summer;7(2):488-501. doi: 10.1215/03616878-7-2-488.
Competition has become a popular prescription for the problem of rising health costs. One issue largely absent fom discussions of market systems and medicine, however, has been analysis of the implications for the poor. This paper explores the implications of proposals to use health maintenance organizations and vouchers to promote competition. We conclude that, as they stand, pro-competitive proposals could cause a significant deterioration in the position of the poor, especially if costs continue to rise, and that their effects are likely to be exacerbated by problems with implementation.
竞争已成为解决医疗成本不断上涨问题的常用手段。然而，在关于市场体系与医疗的讨论中，一个很大程度上被忽视的问题是对穷人影响的分析。本文探讨了利用健康维护组织和代金券来促进竞争的提议所带来的影响。我们得出结论，就目前而言，支持竞争的提议可能会使穷人的处境显著恶化，尤其是在成本持续上升的情况下，而且实施过程中的问题可能会加剧其影响。
