Werlin S H, Walcott A, Joroff M
N Engl J Med. 1976 Sep 23;295(13):698-703. doi: 10.1056/NEJM197609232951304.
The National Health Planning and Resources Development Act of 1974 (PL 93-641) melds the Hill-Burton program, Regional Medical Program and Comprehensive Health Planning into a new network for health planning and resources development. Health-systems agencies will possess broader powers than predecessor agencies, particularly in the areas of regulation, control of federal funds, resources development and implementation. PL 93-641 thus offers the possibility of transforming the basic concept of health planning from reactive to "proactive." Successful legislative implementaion will require each health-systems agency to build local legitimacy, ensure constructive consumer/provider dialogue, and respond to state and national managerial requirements. Many questions about planning implementation, the role of subarea councils, agency co-ordination and local governance remain unresolved. The new health-planning network has the potential to assume the function of active system transformation, but will be critically dependent on adequate program budgeting to fulfill this promise. (N Engl J Med 295:698-703, 1976).
1974年的《国家卫生规划与资源开发法案》（第93 - 641号公法）将希尔 - 伯顿计划、区域医疗计划和综合卫生规划合并为一个新的卫生规划与资源开发网络。卫生系统机构将拥有比其前身机构更广泛的权力，特别是在监管、联邦资金控制、资源开发和实施等领域。因此，第93 - 641号公法提供了将卫生规划的基本概念从被动反应转变为“主动出击”的可能性。成功的立法实施将要求每个卫生系统机构建立地方合法性，确保消费者/提供者进行建设性对话，并回应州和国家的管理要求。许多关于规划实施、分区委员会的作用、机构协调和地方治理的问题仍未得到解决。新的卫生规划网络有可能承担起积极的系统变革职能，但将严重依赖充足的项目预算来兑现这一承诺。（《新英格兰医学杂志》295:698 - 703, 1976）
