Gray G
Australian National University.
J Health Polit Policy Law. 1998 Dec;23(6):905-47. doi: 10.1215/03616878-23-6-905.
Health policy changes intended to achieve cost control in OECD countries run the risk of reintroducing financial barriers to health care. However, although the problems faced are similar, different countries are dealing with the situation in different ways. For example, Canada and Australia, which share many similarities, have taken quite different policy paths in the last decade: Canada has preserved universal access, whereas Australian policy is promoting a two-tier system through the provision of public subsidies for private insurance. The evidence is that country-specific factors such as institutional arrangements, attitudes, and values intersect with economic and financial factors to shape policy outcomes. Moreover, the Canadian and Australian experiences suggest that in relation to access issues, attitudes and values are the key policy determinants.
经合组织国家旨在实现成本控制的卫生政策变革存在重新引入医疗保健财务障碍的风险。然而，尽管面临的问题相似，但不同国家应对这种情况的方式却有所不同。例如，加拿大和澳大利亚有许多相似之处，但在过去十年中却采取了截然不同的政策路径：加拿大保留了全民医保，而澳大利亚的政策则通过为私人保险提供公共补贴来推动两级医疗体系。有证据表明，诸如制度安排、态度和价值观等特定国家因素与经济和金融因素相互交织，从而塑造政策结果。此外，加拿大和澳大利亚的经验表明，在获取医疗服务问题上，态度和价值观是关键的政策决定因素。
