Freidson E
Med Care. 1978 Dec;16(12):971-83. doi: 10.1097/00005650-197812000-00001.
The enormous variety of diagnoses and prescriptions for dealing with the health care crisis in the United States can be simplified and clarified by reference to four logically distinct models of methods for organizing the production of health services. The assumptions of the free market model, the bureaucratic planning model, the professional model and the cooperative equalitarian model are described, as are the characteristic pathologies connected with the form those models take in reality. The intrinsically expansionist character of the manufacturing, service and consumer segments of the U.S. health system is described and the suggestion made that legislative attempts to contain costs will lead to increased bureaucratization primarily at the expense of the consumer.
通过参考四种逻辑上截然不同的医疗服务生产组织方法模型,可以简化和阐明美国应对医疗保健危机的各种各样的诊断和处方。文中描述了自由市场模型、官僚计划模型、专业模型和合作平等主义模型的假设,以及与这些模型在现实中呈现的形式相关的典型弊病。文中还描述了美国医疗系统中制造业、服务业和消费者部门固有的扩张主义特征,并提出立法控制成本的尝试将主要以消费者为代价导致官僚化加剧的观点。