自1965年以来的医疗补助的政治发展:一个碎片化和不平等的计划是如何扩展的
1University of Chicago.
Journal of health politics, policy and law
|September 27, 2024
概括
60多年来,医疗补助 (医疗援助计划) 从限制性发展到扩展性覆盖. 联邦制和私营部门的主导地位等结构性因素推动了这种增长,使得尽管有政治话语,但回滚变得困难.
科学领域:
- 卫生政策 卫生政策
- 公共卫生 公共卫生
- 卫生经济学 卫生经济学
背景情况:
- 医疗补助计划在60多年中经历了重大的转型.
- 它最初是限制性的,现在提供了更广泛的覆盖范围,无论个人情况如何.
研究的目的:
- 分析医疗补助计划的演变和扩张.
- 确定推动医疗补助计划变化的关键结构因素.
- 检查围绕医疗补助的覆盖和融资的政治话语.
主要方法:
- 医疗补助计划变化的历史分析.
- 检查结构特征:联邦制,私营部门参与,分裂.
- 分析政治话语和意识形态紧张局势.
主要成果:
- 医疗补助计划远远超出了最初的范围,覆盖了包括"医疗需要"在内的各种人群.
- 联邦制,私营部门的主导地位和分裂是计划扩张的关键驱动力.
- 政治话语经常将医疗补助作为对污名化群体的补贴,掩盖了其对中产阶级的影响.
结论:
- 由于结构性和政治因素,医疗补助的扩张是深入嵌入的.
- 尽管有政治挑战和意识形态紧张,但扭转医疗补助的增长是极不可能的.
- 了解这些动态对于未来的卫生政策讨论至关重要.
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