Understanding the flow of health policy in the United States: self-interest or ignorance?

S O Schweitzer
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Abstract

Health policy decisions are made in an uneven manner, eluding attempts to explain developments with a coherent theory. Numerous explanations have been suggested to explain individual policy actions, but recently Feldstein has attempted a broader formulation. This Self-Interest Model of Health Policy, however, assumes full knowledge of a policy's benefits and costs. This is an unrealistic assumption, and the model is unable to explain important decisions that have been made in three areas: insurance for long-term care, universal access, and efficiency incentives. This article presents a broader, more powerful formulation of the Feldstein model, specifically incorporating public ignorance as a policy determinant. The vital role of education and health policy research is underscored.

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了解美国卫生政策的流向:自身利益还是无知?
卫生政策决定是以不平衡的方式做出的,无法用连贯的理论解释事态发展。人们提出了许多解释来解释个别的政策行动,但最近费尔德斯坦尝试了一个更广泛的表述。然而,这种卫生政策的自利模式假定充分了解一项政策的收益和成本。这是一个不切实际的假设,该模型无法解释在三个领域做出的重要决定:长期护理保险、普遍可及和效率激励。本文提出了费尔德斯坦模型的更广泛、更有力的表述,特别是将公众无知纳入政策决定因素。强调了教育和卫生政策研究的重要作用。
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Collaborative production and resource allocation: the consequences of prospective payment for hospital care. Hospital demand for physicians. An economic perspective on health politics and policy. Health policy revolution: the search for minimum supply price. Understanding the flow of health policy in the United States: self-interest or ignorance?
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