Derickson A
Department of Labor Studies and Industrial Relations, Pennsylvania State University, University Park., USA.
Am J Public Health. 1997 Nov;87(11):1836-43. doi: 10.2105/ajph.87.11.1836.
The onset of the Cold War had a blighting effect on the campaign for a national health insurance program in the United States. In the highly charged atmosphere of the late 1940s, proponents of social insurance spent considerable time and energy denying that they were agents of foreign powers. In one widely promoted conspiratorial formulation, some on the right traced the origins of subversion not only to Moscow but also to Geneva, Switzerland, home of the International Labor Organization. In the fractiously partisan context of the period, conservative political leaders amplified concerns over disloyal bureaucrats' manipulating the levers of legislative politics as well as the design of health policy. One federal official in particular, I. S. Falk, became the object of outright demonization. The paranoid attacks took their toll on the drive to extend social protection. The reformers' difficulties suggest the limitations of heavy dependence on bureaucratic expertise in the pursuit of health security.
冷战的爆发对美国全国医疗保险计划的推进产生了不利影响。在20世纪40年代末高度紧张的氛围中,社会保险的支持者花费了大量时间和精力来否认自己是外国势力的代理人。在一种广泛传播的阴谋论说法中,一些右翼人士不仅将颠覆的根源追溯到莫斯科,还追溯到瑞士日内瓦,即国际劳工组织的所在地。在那个党派纷争激烈的背景下,保守派政治领导人加剧了人们对不忠的官僚操纵立法政治杠杆以及健康政策设计的担忧。特别是一位联邦官员I.S.福尔克,成了被彻底妖魔化的对象。这些偏执的攻击给扩大社会保护的努力带来了损失。改革者面临的困难表明,在追求健康保障方面过度依赖官僚专业知识存在局限性。