Weil L A
J Public Health Policy. 1997;18(1):30-48.
The fringe benefits on which most Americans have come to rely for health insurance constitute a critical foundation of both the postwar regime of labor relations and the distinctive American welfare state. One legacy of these complementary regimes was a wide variety of institutional commitments and organizational arrangements in the area of health benefits. That diversity of experiences created a range of political incentives for unions when it came to health reform. Thus, when President Clinton proposed a "managed competition" approach to health reform in 1993, divisions within the labor movement contributed to the ineffectiveness of the campaign mounted by supporters of the effort. This article reviews the development of a "private-sector welfare state" in the United States, documents the range of accompanying institutional arrangements, and suggests how they may have shaped the political calculations of certain unions when faced with the Clinton White House's reform proposal.
大多数美国人赖以获取医疗保险的附加福利，构成了战后劳资关系制度以及独特的美国福利国家的关键基础。这些互补制度的一个遗留产物，是在健康福利领域存在各种各样的制度承诺和组织安排。这种经历的多样性在健康改革方面为工会创造了一系列政治激励因素。因此，1993年克林顿总统提出“管理式竞争”的健康改革方法时，劳工运动内部的分歧导致了该改革支持者发起的运动成效不佳。本文回顾了美国“私营部门福利国家”的发展，记录了伴随而来的一系列制度安排，并指出它们在面对克林顿政府的改革提议时，可能是如何影响某些工会的政治考量的。
