Jost T S, Hughes D, McHale J, Griffiths L
Ohio State University, USA.
J Health Polit Policy Law. 1995 Winter;20(4):885-908. doi: 10.1215/03616878-20-4-885.
The health care systems of the United States and the United Kingdom are changing rapidly. After the Thatcher government's 1989 white paper, the formerly unified British National Health Service (NHS) was split into purchaser and provider sides, with the NHS District Health Authorities becoming purchasers, and the NHS hospitals, now reconstructed as independent NHS trusts, becoming providers. The U.S. health care system, driven by market forces rather than government fiat, has been moving rapidly toward integration, with increasingly formalized purchaser and provider relationships. Contracts are found at the purchaser/provider interface in both systems. We reviewed American and British purchaser/provider contracts. The contracts address similar issues but often take disparate approaches. These dissimilarities illuminate the profound, continuing differences between the two systems. They also, however, offer possibilities to transfer contracting "technology" between the two contracting cultures.
美国和英国的医疗保健系统正在迅速变革。在撒切尔政府1989年发布白皮书之后，此前统一的英国国民医疗服务体系（NHS）被划分为采购方和供应方，NHS地区卫生局成为采购方，而如今重组为独立NHS信托机构的NHS医院则成为供应方。受市场力量而非政府指令驱动的美国医疗保健系统一直在迅速走向整合，采购方和供应方的关系日益正规化。在这两个系统的采购方/供应方界面都能找到合同。我们审查了美国和英国的采购方/供应方合同。这些合同处理类似的问题，但往往采取不同的方法。这些差异揭示了这两个系统之间深刻且持续存在的差异。然而，它们也为在两种合同文化之间转移合同“技术”提供了可能性。
