米国における医療:お金が使命になった

Adam Gaffney¹, Steffie Woolhandler², David U Himmelstein²

¹Department of Medicine, Harvard Medical School, Boston, MA, USA; Department of Medicine, Cambridge Health Alliance, Cambridge, MA, USA.

Lancet (London, England)

|October 24, 2025

まとめ

アメリカの医療制度は保険や医療の利益に依存しているため苦戦しています医療のアクセスと質を向上させるために投資家の利益よりも患者の福祉を優先させる必要があります

科学分野:

健康政策
医療経済学
公衆衛生

背景:

アメリカの医療制度は相当な資源があるにも関わらず不十分なパフォーマンスを示しています
何十年にも渡って市場に基づいた保険は保険会社や保険業者の間で利益を追求することを奨励してきました
メディケイドやメディケアのような公共のプログラムは民間保険会社によって管理され費用が上がり患者のケアが制限されています

研究の目的:

商業化が米国保健医療システムに及ぼす悪影響を分析する.
利益主導の政策と民間資本が医療提供に与える影響を評価する.
より公平で効果的な医療制度のために必要な改革を提案する.

主な方法:

市場ベースの医療政策とその結果の検討
医療における民間保険会社と民間資本の役割の分析
政府の政策 (バイデン政権とトランプ政権) の医療への影響に関する調査.
潜在的な改革戦略の評価

主要な成果:

保険会社や医療提供者の利益追求は市場に基づいた政策によってアメリカ保健医療システムに損害を与えています
公的プログラムや民間資本を管理する企業を含む民間企業は患者のケアよりも株主の利益を優先します
メディケイドの削減やメディケアの民営化の加速など最近の政治行動は問題を悪化させました

結論:

現在の政策と利益の動機は医療のアクセスと質に悪影響を及ぼしています
患者の権利と投資家の要求のバランスを取ろうとするだけでは不十分です
保険と介護サービスの非商業化を含む根本的な改革が必要である.

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