美国的医疗保健:钱已经成为使命
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
概括
美国的医疗保健系统由于以利为导向的保险和护理政策而陷入困境. 改革必须优先考虑患者的福祉而不是投资者的利, 以改善医疗保健的获取和质量.
科学领域:
- 卫生政策
- 医疗经济学
- 公共卫生
背景情况:
- 美国医疗保健系统尽管有大量资源, 但表现不佳.
- 几十年来以市场为基础的保险政策激励了保险公司和提供者寻求利.
- 像医疗补助和医疗保险这样的公共计划越来越多地由私人保险公司管理,
研究的目的:
- 分析商业化对美国医疗保健系统的不利影响.
- 评估以利为导向的政策和私人股权对医疗保健服务的影响.
- 提出必要的改革,使医疗保健系统更加公平和有效.
主要方法:
- 审查基于市场的医疗保健政策及其后果.
- 分析私人保险公司和私人股权在医疗保健中的作用.
- 对影响医疗保健的政府政策 (拜登和特朗普政府) 的审查.
- 评估可能的改革策略.
主要成果:
- 基于市场政策的保险公司和医疗服务提供商的利追求破坏了美国的医疗保健系统.
- 私营公司,包括那些管理公共项目和私人股权的公司,
- 最近的政治行动加剧了问题, 包括削减医疗补助和加速医疗保险私有化.
结论:
- 目前的政策和利动机的影响对医疗保健的获取和质量产生了负面影响.
- 恢复现状或试图平衡患者权利与投资者的要求是不够的.
- 需要进行根本改革,包括保险和护理服务的非商业化.
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