美国医疗保健和州区域政策发展中的空间不平等动态

Q4 Social Sciences Perspectives on Federalism Pub Date : 2022-03-28 DOI:10.21686/2073-1051-2022-1-130-149
V. Minat
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引用次数: 1

摘要

揭示经济发达国家社会福利分配不均的本质的关键方面之一是空间不平等的动态,这已经成为美国医疗保健部门几十年来的特征。根据相应指标组的组内和组间特征,对Theil指数进行了分解,将这种不平等作为一个具有历史主义性质的动态过程进行了实证研究,结果表明,在向人口提供医疗福利方面,地区两极分化加剧。鉴于美国公民医疗保健在组织和经济上的不一致,以及美国医疗产品和服务相关市场中自发和自由定价的商业性质占主导地位,美国医疗保健发展中的中心-边缘不平等空间结构,传统上是资本主义再生产的,得到了证实。这种结构长期形成的客观性质,还辅之以国家对分区域和跨区域部分的卫生保健进行区域管理这一主观因素,这一主观因素是通过实施不同方向的类型相关政策——从传统的和主动的到选择性的。研究表明,不仅经济状况,而且社会政治和意识形态的权宜之计,都是决定在美国特定地区激活、分化、刺激或抑制医疗保健发展的工具的主题。
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Dynamics of Spatial Inequality in the Development of us Healthcare and State Regional Policy
One of the key aspects that reveals the essence of the uneven distribution of social benefits in economically developed countries is the dynamics of spatial inequality that has been characteristic of the US healthcare sector for many decades. The results of an empirical study of this inequality as a dynamic process with the properties of historicism, carried out by decomposition of the Theil index according to the intragroup and intergroup characteristics of the corresponding groups of indicators, indicate an increase in the polarization of territories in terms of the provision of the population with medical benefits. Given the organizational and economic inconsistency in the health care of American citizens and the predominance of the spontaneous and commercial nature of free pricing in the relevant markets of American medical goods and services, the center-peripheral spatial structure of inequality in the development of US health care, traditional for capitalist reproduction, is confirmed.The objective nature of the long-term formation of such a structure is complemented by the subjective factor of state regional regulation of health care in the subregional and transregional sections, through the implementation of differently directed typologically relevant policies – from traditional and proactive to selective. It is shown that not only the economic situation, but also the socio-political and ideological expediency are the subjects that determine the tools for activating, polarizing, stimulating or restraining the development of healthcare in specific areas of the United States.
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来源期刊
CiteScore
0.10
自引率
0.00%
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0
审稿时长
5 weeks
期刊介绍: Perspectives on Federalism is an Open Access peer-reviewed journal, promoted by the Centre for Studies on Federalism. This initiative follows the Bibliographical Bulletin on Federalism’s success, with an average of 15000 individual visits a month. Perspectives on Federalism aims at becoming a leading journal on the subject, and an open forum for interdisciplinary debate about federalism at all levels of government: sub-national, national, and supra-national at both regional and global levels. Perspectives on Federalism is divided into three sections. Along with essays and review articles, which are common to all academic journal, it will also publish very short notes to provide information and updated comments about political, economic and legal issues in federal states, regional organizations, and international organizations at global level, whenever they are relevant to scholars of federalism. We hope scholars from around the world will contribute to this initiative, and we have provided a simple and immediate way to submit an essay, a review article or a note. Perspectives on Federalism will publish original contributions from different disciplinary viewpoints as the subject of federalism requires. Papers submitted will undergo a process of double blind review before eventually being accepted for publication.
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