Lightfoote J B, Ragland K D
MEMRAD Medical Group, Beverly Hospital, Montebello, CA 90640, USA.
J Natl Med Assoc. 1996 Apr;88(4):217-24.
Leaders in both government and the health-care industry have strong and varied opinions regarding the present US health-care system, but concur that health-care financing and organization need restructuring. The single-payer system offers the best framework for improving health-care universality, delivery, quality, access, choice, and cost effectiveness. However, the single-payer alternative often is dismissed early in debates on health-care reform. Popular aversion to collective governmental funding of health-care costs and the economic interests of the management, insurance, information, and profit sectors of the health-care industry are the critical impediments to adoption of single-payer insurance systems. This article examines the psychosocial and economic obstacles that prevent development of an efficient and effective health-care system and preclude recognition of the single-payer system as the best answer to health-care reform.
政府和医疗行业的领导者对当前美国医疗体系有着强烈且多样的看法，但他们一致认为医疗融资和组织需要进行重组。单一支付者体系为改善医疗普及性、服务、质量、可及性、选择以及成本效益提供了最佳框架。然而，在医疗改革辩论初期，单一支付者方案往往就被摒弃了。民众对政府集体资助医疗费用的反感以及医疗行业管理、保险、信息和盈利部门的经济利益，是采用单一支付者保险体系的关键障碍。本文探讨了阻碍高效医疗体系发展并妨碍将单一支付者体系视为医疗改革最佳答案的社会心理和经济障碍。
