Smith E B
University of Pittsburgh Medical Ctr, PA 15213, USA.
J Natl Med Assoc. 1996 Mar;88(3):161-8.
Since 1960, numerous concepts of health-care reform have been submitted to the US Congress and the American public with different viewpoints and objectives. The priority for the US Congress to pass a bipartisan health-reform plan has been circumvented by the newly elected majority Republican Congress. Nevertheless, health-care cost containment, quality control, and health-care delivery concepts have been implemented gradually into the concept of competitive managerial health care. A few of the serious problems in the African-American community are the efficiency and quality of the health-care delivery system and the effects of managed care on African-American primary physicians and surgical specialists. The critical shortages of this group, especially the latter, may create a dilemma in the implementation of a quality surgical care delivery system. The Association of American Medical Colleges, the American College of Surgeons, and other affiliating organizations should become sensitized to the African-American community's health needs, deficiencies, and the rational institution of an equitable, efficient, comprehensive, and quality health-care plan coupled with a sustained and increasing supply of certified, diversified, and experienced African-American surgical manpower in company with family practice physicians and primary care physicians.
自1960年以来,众多医疗改革理念被提交给美国国会和美国公众,这些理念有着不同的观点和目标。新当选的占多数的共和党国会回避了美国国会通过两党合作医疗改革计划的首要任务。尽管如此,医疗成本控制、质量控制和医疗服务理念已逐渐融入竞争性管理型医疗保健概念之中。非裔美国人社区存在的一些严重问题包括医疗服务体系的效率和质量,以及管理型医疗对非裔美国初级内科医生和外科专家的影响。这一群体,尤其是后者的严重短缺,可能会给优质外科护理服务体系的实施带来困境。美国医学院协会、美国外科医师学会以及其他附属组织应该更加关注非裔美国人社区的健康需求、不足,合理制定一个公平、高效、全面且优质的医疗保健计划,并持续增加有资质、多样化且经验丰富的非裔美国外科人力供应,同时配备家庭医生和初级保健医生。