Brown L D
Columbia University, USA.
J Health Polit Policy Law. 1998 Feb;23(1):35-51. doi: 10.1215/03616878-23-1-35.
American health care reformers, who often look to other nations for models of desirable health systems, are often surprised nowadays by cross-national infatuation with health policy innovations minted in the United States. American innovations appeal to policy makers abroad as they struggle with cost pressures, distinguish knowledge about how health systems work, and deal with changing images of what constitutes good public policy. These strategems are adapted, not adopted; however, the premises and practices with which other nations follow American directions differ deeply from those in the United States. Ironically, even cross-national experiments may end up offering instructive policy "rules" to the exceptionalist United States.
美国医疗保健改革者常常借鉴其他国家的理想医疗体系模式，而如今他们却常常惊讶于其他国家对美国首创的医疗政策创新的痴迷。美国的创新举措吸引了国外的政策制定者，因为他们面临成本压力、需要厘清医疗体系如何运作的知识，以及应对关于良好公共政策构成要素不断变化的观念。这些策略是被调整而非被采用；然而，其他国家遵循美国方向时的前提和做法与美国大相径庭。具有讽刺意味的是，甚至跨国实验最终可能会为秉持例外主义的美国提供具有启发性的政策“规则”。
