Brown L D
Columbia University.
J Health Polit Policy Law. 1993 Summer;18(2):339-57. doi: 10.1215/03616878-18-2-339.
For more than a decade students of health policy have predicted a revolution waged by corporate purchasers of health care who would rise in demand of public policy cures for increasing and burdensome health care costs. This forecast has been largely disappointed, however, as the business sector has remained oddly diffident in its demands for health policy reform. There are three reasons for business's reticence--the economic stakes of the corporate sector in health reform are uncertain, organizational encumbrances hamper business activism in this arena, and ideological convictions make business wary of governmental solutions. Although business is sometimes said to manipulate the policy process for its own material ends, in the health sphere the most likely road to reform may reverse this image: a newly activist federal government may have to mobilize business support for reforms that advance both corporate interests and larger social goals.
十多年来，卫生政策专业的学生一直预测，医疗保健企业购买者将发起一场变革，他们会增加对公共政策的需求，以解决日益增加且负担沉重的医疗保健成本问题。然而，这一预测在很大程度上未竟其然，因为商业部门在对卫生政策改革的需求上一直出奇地缺乏热情。商业部门保持沉默有三个原因——企业部门在医疗改革中的经济利益不确定，组织上的障碍阻碍了该领域的商业行动主义，以及意识形态信念使企业对政府解决方案持谨慎态度。尽管有时人们认为商业部门为了自身物质利益而操纵政策过程，但在医疗领域，最有可能的改革之路可能会颠覆这种印象：一个新的积极行动的联邦政府可能不得不动员企业支持那些既推进企业利益又促进更大社会目标的改革。
