过去20年的卫生政策:改革与反改革

本文探讨了过去20年来卫生改革的不同阶段特征。20世纪90年代初,改革的主要目标是赋予患者更多的选择权和在卫生体系中引入更激烈的竞争;1995—2000年,目标发生逆转,致力于卫生系统的整合和规制;进入2000年以来,政策热点转向强化患者权利。为了探寻这些改革策略背后隐藏的动机,文章分析了经济合作与发展组织成员国法国、德国、荷兰、新西兰、瑞典和英国的改革实例,旨在揭示执政政府的意识形态倾向是如何影响改革措施内容的。

Healthcare policies over the last 20 years: reforms and counter reforms

The case argued in this article is that the last two decades have been characterised by distinct waves of healthcare reforms. The first, in the early 1990s, aimed to introduce more patients＇ choice and greater competition between the components of the healthcare system. The second, from 1995 to 2000, had the opposite aim of introducing greater integration and regulation. From 2000 onwards, the policy issue more in vogue has been the strengthening of patients＇ rights. Looking for the motives behind these reform strategies, this article aims to show how the ideological leaning of the governments in power affects the content of reform initiatives. The analysis presents evidence drawn from six OECD countries： France, Germany, the Netherlands, New Zealand, Sweden and UK.