Автор: Пользователь скрыл имя, 12 Марта 2012 в 15:07, статья
Критики американской системы здравоохранения часто предлагают реформировать ее, воспользовавшись иностранными образцами. Они указывают: во многих государствах расходы на здравоохранение гораздо меньше, чем в США, а эффективность медицинских услуг — выше. Соединенным Штатам следует взять на вооружение зарубежный опыт, настаивают эти скептики, и создать государственную систему здравоохранения.
28 "Stronach Went to US for Cancer
Treatments: Report," CTV, September 14, 2007, http://www.ctv.ca/servlet/
29 Steve Findlay, "US Hospitals Attracting Patients from Abroad," USA Today, July 22, 1997.
30 Две главные причины, по которым пациентов направляли в зарубежные медицинские учреждения, заключались в отсутствии соответствующих возможностей лечения в Канаде (40%), и длинной очереди на определенные виды медицинских услуг (19%) (Robert J. Blendon et al., "Physicians' Perspectives on Caring for Patients in the United States, Canada, and West Germany," New England Journal of Medicine 328, no. 14 (1993): 1011-16).
31 John Goodman "Moore's SiCKO
Could Put Lives at Risk," The Michael Moore Chronicles, National
Center for Policy Analysis, 2007, http://sicko.ncpa.org/moores-
32 "Nobel Prize in Physiology or
Medicine Winners 2007-1901," The Nobel Prize Internet Archive,
http://almaz.com/nobel/
33 Pharmaceutical Research and Manufacturing of America, "R&D Spending by US Biopharmacetical Companies Reaches a Record $ 55,2 Billion in 2006," February 12, 2007.
34 Economic Report of the President (Washington: Government Printing Office, 2004), p. 192.
35 Gerard Anderson et al., "It's the Prices Stupid: Why the United States Is So Different from Other Countries," Health Affairs 22, no. 3 (2003): 99.
36 Oliver Schoffski, "Diffusion of Medicines in Europe," доклад, подготовленный для Европейской федерации фармацевтических предприятий и ассоциаций в 2002 году. Цит. по: Daniel Kessler, "The Effects of Pharmaceutical Price Controls on the Cost and Quality of Medical Care: A Review of the Empirical Literature" (исследование подготовлено для Комиссии по международной торговле США).
37 Ibid.
38 Так, по некоторым данным,
чересчур интенсивное использование компьютерной
томографии в США, особенно при обследовании
детей, возможно, повышает риск некоторых
раковых заболеваний (см.: David Brenner and Eric
Hall, "Computed Tomography: An Increasing Source of Radiation Exposure,"
New England Journal of Medicine 357, no. 22 (2007): 2277-84). В то
же время, по другим сведениям, широкое
использование этой технологии сокращает
смертность от других видов рака, например,
рака легких (International Early Lung Cancer Investigators,
"Survival of Patients with Stage I Lung Cancer Detected on CT Screening,"
New England Journal of Medicine 355, no. 17 (2006): 1763-71). Робин
Хэнсон из Университета им. Джорджа Мейсона
утверждает, что в США значительная часть
расходов на здравоохранение вообще не
дает позитивной отдачи для кого бы то
ни было. По его мнению, мы могли бы сократить
эти расходы на 50% без какого-либо снижения
эффективности медицинской помощи (Robin
Hanson, "Cut Medicine in Half," Cato Unbound, September 10,
2007, http://www-cato-unbound.org/
39 Ohsfeldt and Schneider, The Business of Health. Джонатан Кон справедливо отмечает, что значительная часть - хотя и далеко не все - фундаментальных исследований в этой обрасти финансируется государственными институтами здравоохранения (Jonathan Cohn, "Creative Destruction: The Best Case Against National Health Care," The New Republic, November 12, 2007). Однако основная часть прикладных медицинских разработок осуществляется на средства частного сектора. В целом на долю частных компаний приходится до 57% всех расходов на биомедицинские исследования. В 1989-2002 годах в Америке частные структуры инвестировали в создание биотехнологий в четыре раза больше средств, чем во всех странах Европы. См.: Tyler Cowen, "Poor US Scores in Health Care Don't Measure Nobels or Innovation," New York Times, October 5, 2006.
40 Tyler Cowen, "Poor US Scores in Health Care Don't Measure Nobels or Innovation".
41 "The Novartis Warning," Wall Street Journal, May 8, 2002.
42 См. Alain Enthoven, "The History and Principles of Managed Competition," Health Affairs 12, suppl. 1 (1993): 24-48.
43 Michael Tanner, "No Miracle in Massachusetts: Why Governor Romney's Health Care Reform Won't Work," Cato Institute Briefing Paper no. 97, June 6, 2006.
44 Jonathan Cohn, Sick: The Untold Story of America's Health Care Crisis - And the People Who Pay the Price (New York: HarperCollins, 2007), p. 226.
45 Ezra Klein, "Health Care Wrap
Up," www.ezraklein.com, April 25, 2005: http://www.prospect.org/csnc/
46 Mattke et al., "Health Care Quality Indicators Project".
47 Victor Rodwin, "The Health Care System under French National Health Insurance: Lessons for Health Reform in the United States," American Journal of Public Health 93, no. 1 (2003): 34. Отметим, что общее налоговое бремя превышает долю ВВП, идущую на систему здравоохранения, поскольку за счет налогов финансируются расходы на медицинское страхование неработающего населения - детей, стариков и безработных.
48 Philippe Maniere et al., "Perspectives on the European Health Care Systems: Some Lessons for America," Heritage Foundation Lecture no. 711, July 9, 2001.
49 "French Health Insurance System to Post 10.3-Billion-Euro Deficit," EU Business, August 6, 2006.
50 "Deficit-Saddled France Under Fire over Budget," Reuters, July 5, 2007. Бюджетный дефицит в странах зоны евро не должен превышать 3% ВВП.
51 "French Health Care Is Badly Run," BBC News, August 8, 2006.
52 Martine Bellanger, Veneta Cherilova, and Valerie Paris, "The Health Benefit Package in France," European Journal of Health Economics 6, suppl. 1 (2005): 24-29.
53 Simone Sandier et al., "France," в кн. Health Care Systems in Transition, eds. Sarah Thomson and Elias Mossialos (Brussels: The European Observatory on Health Care Systems, 2004).
54 Thomas Buchmueller and Agnes Couffinhal, "Private Health Insurance in France," OECD Health Working Paper no. 12, 2004. В этом смысле, по крайней мере, французские врачи обладают большей свободой действий, чем их американские коллеги, которым в рамках Medicare запрещено предъявлять пациентам дополнительные счета за услуги, обеспеченные страховым покрытием.
55 Francesca Columbo and Nicole Tapay, "Private Health Insurance in the OECD Countries: The Benefits and Costs for Individuals and Health Systems," OECD Health Working Paper no. 15, 2004.
56 OECD, "OECD Health Data 2007: Statistics and Indicators for 30 Countries."
57 Buchmueller and Couffinhal, "Private Health Insurance in France." Необходимо отметить, однако, что эта дерегулированная система страхования относится только к дополнительному покрытию. Ни один гражданин не может лишиться права на базовую государственную страховку, по основаниям, связанным с состоянием здоровья.
58 Ibid.
59 Rodwin, "The Health Care System under French National Health Insurance."
60 Ibid.
61 Valentin Petkantchin, "Pernicious
Myths about Public Health Insurance in France," Economic Note (Brussels:
Institut Economique Molinari, 2007), http://www.institutmolinari.
62 "La Securite Social," отчет французской Счетной палаты, сентябрь 2006 г.
63 Maniere et al., "Perspectives on the European Health Care Systems."
64 Paul Dutton, "Health Care in France and the United States: Learning from Eah Other," Brookings Institution, July 2002.
65 Rodwin, "The Health Care System under French National Health Insurance."
66 Alexander Dorozynski, "French Health Staff Strike over Budget Cuts," British Medical Journal 320 (February 2000): 333; Alexander Dorozynski, "French Medical System Beset by Strikes," British Medical Journal 324 (February 2002): 258.
67 Высший совет по перспективам медицинского страхования, "L'Avenir de l'Assurance Maladie: L'Urgence d'un Redressment par la Qualite" (Paris: Ministere de la Sante Publique, 2004).
68 Valentin Petkatchin, "The Ineffectiveness
of Health Cost Containment Policies in France," Economic Note (Brussels:
Institut Economique Molinari, 2007); http://www.institutmolinari.
69 OECD, "OECD Health Data 2007: Statistics and Indicators for 30 Countries."
70 Rodwin, "The Health Care System under French National Health Insurance."
71 Petkatchin, "The Ineffectiveness of Health Cost Containment Policies in France."
72 Norman Ho, "A Long, Hot Summer," Harvard International Review 26 (Summer 2004); "French Health Care Is Badly Run," BBC News, January 23, 2004.
73 Valentin Petkantchin, "Bureaucratic Drug De-listing: The French Example," EU Reporter, January-February 2007.
74 Schoffski, "Diffusion of Medicines in Europe."
75 "French Health Care Is Badly Run," BBC News, January 23, 2004
76 D. Benamouzig and R. Launois, "Rationing Health Care in Europe-France," в кн. Rationing Health Care in Europe: An Empirical Study, eds. J. Matthias Graf von der Schulenburg and Michael Blank (Amsterdam: IOS Press, 2004), p. 16.
77 Helen Disney et al., Impatient for Change: European Attitudes to Healthcare Reform (London: Stockholm Network, 2004), pp. 69-86.
78 Institut Economique Molinari, "Health
Myths in France: More Competition, Not Cost Containment Is the Solution
According to the French Institut Economique Molinari," пресс-релиз
от 7 января 2007 г., www.institutmolinari.org/pubs/
79 Dorozynski, "French Health Staff Strike over Budget Cuts."
80 Columbo and Tapay, "Private Health Insurance in the OECD Countries."
81 Hurst and Luigi Siciliani, "Tackling Excessive Waiting Times for Elective Surgery: A Comparison of Policies in Twelve OECD Countries," OECD Health Working Paper no. 6, July 2003.
82 Ezra Klein, "The Health of Nations: Here's How Canada, France, Britain, Germany, and our Own Veterans Health Administration Manage to Cover Everybody at Less Cost and with Better Care than We Do," American Prospect, April 24, 2007.
83 Evan Doorslaer et al., "Income-Related Inequality in the Use of Medical Care in 21 OECD Countries," в кн. Towards High Performing Health Systems: Policy Studies from the OECD Health Project (Paris: OECD, 2004).
84 Rodwin, "The Health Care System under French National Health Insurance."
85 Disney et al., Impatient for Change, pp. 69-86.
86 Ibid.
87 "Sarkozy's Election Reflects Europe's Right Turn," National Public Radio, May 7, 2007.
88 "Budget 2008: Tighter Controls
on Healthcare Spending as French Conservatives Crack Down on Social
Security Deficit," Global Insight, 2007, http://www.globalinsight.com/
89 Mattke et al., "Health Care Quality Indicators Project."
90 Alexandra Bibbee and Benoit Bellone, "Economic Survey of Italy, 2007" (Paris: OECD, 2007).
91 Andrea Donatini et al., Health Care Systems in Transition: Italy (Copenhagen: European Observatory on Health Systems and Policies, 2001).
92 Franco Reviglio, "Health Care and Its Financing in Italy: Issues and Reform Options," IMF Working Paper 00-166, October 2000.
93 Donatini et al., Health Care Systems in Transition: Italy.
94 Reviglio, "Health Care and Its Financing in Italy."
95 Это зависит от региона, где проживает пациент, и предвыборного цикла. Зачастую долевое участие в оплате лекарств отменяется накануне выборов.
96 Daniel Callahan and Angela Wasunna, Medicine and the Market: Equity v. Choice (Baltimore: Johns Hopkins University Press, 2006), p. 98.
97 Donatini et al., Health Care Systems in Transition: Italy.
98 Callahan and Wasunna, Medicine and the Market: Equity v. Choice, p. 93.
99 Vincenzo Atella and Federico Spandanaro, "Private Health Insurance in Italy: Where We Stand Now," Euro Observer, Spring 2004.
100 Callahan and Wasunna, Medicine and the Market: Equity v. Choice, p. 97.
101 George France, Francesco Taroni, and Andrea Donatini, "The Italian Health Care System," Health Economics 14 (September 2005): 185-202.
102 Alberto Mingardi, "A Drug Price Path to Avoid," Washington Post, November 12, 2006.
103 См. напр. "Italy Hit by Double Strike," BBC News, February 9, 2004.
104 Reviglio, "Health Care and Its Financing in Italy."
105 OECD, "OECD Health Data 2007: Statistics and Indicators for 30 Countries."
106 Donatini et al., Health Care Systems in Transition: Italy.
107 Mingardi, "A Drug Price Path to Avoid."
108 Ariel David, "Tialian Police Units Inspect Hospitals," Washington Post, January 8, 2007.
109 Vittorio Maio and Lamberto Manzoli, "The Italian Health Care System: WHO Ranking versus Public Perception," PloS Medicine 6 (June 2002): 301-03.
110 Disney et al., Impatient for Change, pp. 111-19.
111 Guillem Lopez-Casanovas, Joan Coasta-Font, and Ivan Planas, "Diversity and Regional Inequalities: Assessing the Outcomes of the Spanish System of Health Care Services," UPF Working Paper no. 745, April 2004.
112 Antonio Duran, Juan Lara, and Michelle van Waveren, "Spain: Health System Review," Health Systems in Transition 8, no. 4 (Copenhagen: European Observatory on Health Systems and Policies, 2006).
113 Ibid.
114 "Waiting to Be Seen: How the Health Service Varies across Spain," Expatica, June 26, 2007.
115 Emilio Cerda, Laura de Pablos, and Maria Rodriguez, "Waiting Lists for Surgery," в кн. Patient Flow: Reducing Delay in Healthcare Delivery (Hoboken, NJ: Springer, 2006).
116 Xavier Bosch, "Spain: The Old Frequently Live with Their Families," British Medical Journal 324 (June 29, 2002): 1543.
117 Существует, правда, одно исключение. Служащие центральных органов власти могут отказаться от государственного страхования: их полисы, приобретаемые у частных структур, оплачивает правительство. И примерно 91% таких госслужащих выбирает частных страховщиков (Noah Clarke, "Government Health Care: A Universal Failure," Today's News, Goldwater Institute, May 10, 2007).
118 Mario Rodriguez, Richard Scheffer, and Jonatan Agnew, "An Update on Spain's Health Care System: Is It Time for Managed Competition?" Health Ploicy 51 (2000): 109-31.
119 Columbo and Tapay, "Private Health Insurance in the OECD Countries."
120 Luis Rajmil et al., "The Quality of Care and Influence of Double Health Coverage in Catalonia (Spain)," Archive of Disease in Childhood 83 (September 2000): 211-14.
121 OECD, "OECD Health Data 2007: Statistics and Indicators for 30 Countries."
122 Duran, Lara and van Waveren, "Spain: Health Systems Review."
123 Rodriguez, Scheffer, and Agnew, "An Update on Spain's Health Care System."
124 Duran, Lara and van Waveren, "Spain: Health Systems Review."
125 Disney et al., Impatient for Change, pp. 151-60.
126 Alastair Kilmarnmock, "Spain: Commentary," в кн. Impatient for Change: European Attitudes to Healthcare Reform, eds. Disney et al., (London: Stockholm Network, 2004), p. 161.
127 Disney et al., Impatient for Change, pp. 151-60.
128 Tetsu Fukawa, "Public Health Insurance in Japan," World Bank Institute Working Paper no. 37201 (2002).
129 Ibid.
130 Kohei Komamura and Atsihuro Yamada, "Who Bears the Burden of Social Insurance? Evidence from Japanese Health and Long-Term Care Insurance Data," Journal of Japanese and International Economics 18 (December 2004): 565-81. v Japanese Health Insurance Industry Faces Winnowing Out," Medical Insurance News, March 21, 2004.
131 Noriyuki Takayama, "Japan's Never-Ending Social Security Reforms," International Social Security review 55 (2002): 11-22.
132 Adam Wagstaff, "Health Systems in East Asia: What Can Developing Countries Learn from Japan and Asian Tigers?" Health Care Economist, April 18, 2007.
133 Shikha Dalmia, "The UAW's Health-Care Dreams," Wall Street Journal, July 27, 2007.
134 M. Ryan Baker, "Japan and Massachusetts: A Comparison of Universal Health Care Systems," Missouri Foundation for Health, Spring 2006.
135 Naoki Ikagami and John Campbell, "Japan's Health Care System: Containing Costs and Attempting Reform," Health Affairs 23 (2004): 29-34.
136 Naoki Ikagami and John Campbell, "Health Care Reform in Japan: The Virtues of Muddling Through," Health Affairs 18 (Fall 1999): 56-57.
138 Ibid.
139 "The Doctor's Dilemma," The Economist, June 10, 2004.
140 Jeong Hyoung-Sun and Jeremy Hurst, "An Assessment of the Performance of the Japanese Health Care System," OECD Labour Market and Social Policy Occasional Paper no. 56, 2001.
141 OECD, "OECD Health Data 2007: Statistics and Indicators for 30 Countries."
142 Aki Yoshikawa and Jayanata Bhattachariya, "Japan," в кн. World Health Systems: Challenges and Perspectives, eds. Bruce Fried and Laura Gaydos (Chicago: Health Administration Press, 2002).
143 Ikagami and Campbell, "Health Care Reform in Japan: The Virtues of Muddling Through."
144 Bill Ross et al., "International Approaches to Funding Health Care," {Australia} Commonwealth Department of Health and Ageing Occasional Papers, Health Financing Series no. 2, 1999.
145 W.C. Hsiao, "Afterward Costs: The Macro Perspective," Containing Health Care Costs in Japan (Ann Arbor: The University of Michigan Press, 1999), pp. 45-52. Хотя в этом исследовании используются не самые последние данные, авторы более поздних трудов поддерживают его выводы: см. Ikagami and Campbell, "Health Care Reform in Japan: The Virtues of Muddling Through"; Ross et al., "International Approaches to Funding Health Care."
146 Rihito Kimura, "Bioethics and Japanese Health Care," Washington-Japan Journal 3 (1994): 2.
147 Takayama, "Japan's Never-Ending Social Security Reforms."
148 Christian Hagist and Laurence J. Kotlikoff, "Health Care Spending: What the Future Will Look Like," National Center for Policy Analysis, Study no. 286, June 28, 2006.
149 Booyeon Lee, "Help Wanted: Is Immigration the Answer to the Shrinking Labor Force," Asahi Shimbun, December 23, 2003.
150 Проблема очередей на лечение и нормирования медицинских услуг приобрела в Норвегии настолько серьезный характер, что в 2000 г. правительство инициировало программу «Мост для пациентов», создающую условия для лечения норвежцев в частных больницах соседних стран. См.: G. Bottom, S. Grepperud, and S.M. Neiland, "Trading Practices: Lessons from Scandinavia," Health Affairs 69 (2004): 317-27.
151 Jan Roth Johnsen, Health Systems in Transition: Norway 8, no. 1 (Copenhagen: European Observatory on Health Systems and Policies, 2006).
152 "Tax Revenues on the Rise in
Many OECD Countries, OECD Report Shows," FinFacts, October 11,
2006; http://www.finfacts.com/
153 Johnsen, Health Systems in Transition: Norway.
154 См. выступление Майкла Мура на премьере «Здравозахоронения» в Вашингтоне 20 июня 2007 года.
155 Johnsen, Health Systems in Transition: Norway.
156 Terje Hagen and Oddvar Kaarboe, "The Norwegian Hospital Reform of 2002: Central Government Takes Over Ownership of Public Hospitals," Health Organization Research Norway (HORN) Working Paper no. 1 (2004).
157 Paul van den Noord, Terje Hagen, and Tor Iversen, "The Norwegian Health Care System," OECD Economics Department Working Paper no. 198, 1998.
158 Johnsen, Health Systems in Transition: Norway.
159 H. Piene, P. Nyen, and H. Hauge, "Waiting Lists and Hospital Capacity - Analyses Based on Theoretical Queue Models and Empirical Data," доклад на ежегодном заседании Международного общества технического анализа здравоохранения в 1997 году.
160 Christine Furuholmen and Jon Magnussen, Health Care Systems in Transition: Norway (Copenhagen: European Observatory on Health Care Systems, 2000).
161 Luigi Siciliani and Jeremy Hurst, "Explaining Waiting Times Variations for Elective Surgery across OECD Countries," OECD Health Working Paper no. 7, October 2003.
162 M Hoel and E. Saether, "Private Health Care as a Supplement to a Public Health System with Waiting Time for Treatment," Ragnar Frisch Center for Economic Research, Oslo, 2000.
163 Цит. по Soren Holm, "Goodbye to the Simple Solutions: The Second Phase of Priority Setting in Health Care," British Medical Journal 317 (October 1998): 1000-02.
164 Hagen and Kaarboe, "The Norwegian Hospital Reform of 2002: Central Government Takes Over Ownership of Public Hospitals."