Koseki L K, Hayakawa J M
Med Care. 1979 Mar;17(3):244-54. doi: 10.1097/00005650-197903000-00002.
This paper reviews ten federal health laws from the perspective of the extent to which consumer participation had been incorporated as an integral aspect of health program, identifies some issues and dilemmas of implementing consumer participation activities, and offers suggestions for the involvement of consumer advocates. The review of the laws showed uncertainty of outcomes, conflicting philosophies, conflicting purposes, conflicting strategies, and conflicts relating to representativeness, legitimacy and consumer role. Despite the inconsistent record of Congress to legislate consumer participation, two recent health laws, P.L. 93-641 and Title III of P.L. 94-63, appear to offer major opportunities in promoting consumer involvement in planning and policy development activities. However, because these laws continue to delegate the responsibility for implementing consumer involvement programs to providers, established institutions and state agencies, consumer advocates are urged to increase their knowledge of the laws and to assist consumers to realize their right of self-determination. The cause is worthy and represents a desirable goal for public health--and in the final analysis, for the survival of our democratic society.
本文从消费者参与在多大程度上被纳入健康项目的一个组成部分这一角度，回顾了十项联邦健康法，识别了实施消费者参与活动的一些问题和困境，并为消费者权益倡导者的参与提供了建议。对这些法律的审查显示出结果的不确定性、相互冲突的理念、相互冲突的目的、相互冲突的策略，以及与代表性、合法性和消费者角色相关的冲突。尽管国会在立法规定消费者参与方面记录不一，但最近的两项健康法，即公法93 - 641和公法94 - 63的第三编，似乎为促进消费者参与规划和政策制定活动提供了重大机遇。然而，由于这些法律继续将实施消费者参与项目的责任委托给提供者、既定机构和州机构，因此敦促消费者权益倡导者增加对这些法律的了解，并协助消费者实现其自决权。这一事业是有价值的，代表了公共卫生的一个理想目标——归根结底，也是我们民主社会生存的理想目标。
