Freeman R
University of Edinburgh.
J Health Polit Policy Law. 1995 Fall;20(3):745-65. doi: 10.1215/03616878-20-3-745.
The gap between rhetoric and reality in health policy making for disease prevention services is well recognized. I do not try once more to close the gap, but rather argue that the rhetoric of prevention is politically significant. Beginning with an account of prevailing explanations of prevention in policy making, I explore the idea that prevention has a pervasive legitimacy in health politics. This affords opportunities for instrumental policy making by government. To this end, I concentrate on the relationship between disease prevention and health care delivery, discussing in detail the association between prevention and health care reform. My arguments are based on case studies of policy making in Germany and the United Kingdom. I discuss implications for understanding the core interests of government, physicians, and users with respect to prevention in health policy making. The concluding section offers comparative commentary on the role of disease prevention in health sector restructuring.
在疾病预防服务的卫生政策制定中，言辞与现实之间的差距已得到广泛认可。我并非试图再次弥合这一差距，而是认为预防的言辞在政治上具有重要意义。从阐述政策制定中对预防的主流解释入手，我探讨了预防在卫生政治中具有普遍合法性这一观点。这为政府进行工具性政策制定提供了机会。为此，我专注于疾病预防与医疗服务提供之间的关系，详细讨论预防与医疗改革之间的关联。我的论点基于德国和英国政策制定的案例研究。我讨论了在理解政府、医生和用户在卫生政策制定中对预防的核心利益方面的影响。结论部分对疾病预防在卫生部门结构调整中的作用进行了比较性评论。
