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政治与医学:以列色国家医疗保险案例

Politics and medicine: the case of Israeli National Health Insurance.

作者信息

Yishai Y

出版信息

Soc Sci Med. 1982;16(3):285-91. doi: 10.1016/0277-9536(82)90338-0.

Abstract

The paper focuses on the attempts to introduce a national health insurance system in Israel. So far all these attempts advanced through six public committees and various legislative initiatives have been futile. The major actors involved in the process of NHI formulation are (a) the sick funds, the largest of which (KH) nearly monopolizes the health services; (b) political parties which are affiliated with the sick funds; (c) the Israeli medical association. The labor oriented parties and sick funds aimed for the introduction of an NHI system which would strengthen KH and preserve its autonomy. The right wing parties and sick fund advocated nationalization of the NHI. The IMA took a mid-way position not identifying with either of the parties. By allying with a small coalition party it was effective in impeding the legislative process that was initiated by the Labor Party. The vigorous opposition of KH has hindered the adoption of the Likud's version of the NHI. Hence, the issue, torn between conflicting parties, reached a stalemate which is not likely to be resolved in the near future.

摘要

本文聚焦于以色列引入国民健康保险制度的种种尝试。到目前为止,所有这些通过六个公共委员会和各种立法倡议推进的尝试都徒劳无功。参与国民健康保险制度制定过程的主要行为体包括:(a)疾病基金,其中最大的(KH)几乎垄断了医疗服务;(b)与疾病基金有关联的政党;(c)以色列医学协会。以劳工为导向的政党和疾病基金旨在引入一个能加强KH并保留其自主权的国民健康保险制度。右翼政党和疾病基金主张国民健康保险制度国有化。以色列医学协会采取了中间立场,不认同任何一方。通过与一个小联合政党结盟,它有效地阻碍了工党发起的立法进程。KH的强烈反对阻碍了利库德集团版本的国民健康保险制度的通过。因此,这个在相互冲突的政党之间陷入困境 的问题陷入了僵局,近期不太可能得到解决。

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