A response to Rudolf Klein: a battle may have been won but perhaps not the war.
A response to Rudolf Klein: a battle may have been won but perhaps not the war.
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对鲁道夫·克莱因的回应：一场战斗可能已经胜利，但也许不是战争。
DOI：
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发表时间：
2013
影响因子：
4.2
通讯作者：
D. Hunter
中科院分区：
文献类型：
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作者：
D. Hunter
英国国民健康服务体系（NHS）正在经历其65年历史上可能是最深远的一系列变化。虽然一些评论家（如鲁道夫·克莱因）坚持认为，实质性的变化不大，但其他人认为，改革的政治可能在这一次证明是完全不同的。联合政府致力于重组福利国家和公共服务，并削减国家。NHS作为一种受欢迎的垄断公共服务与其新自由主义意识形态背道而驰。虽然（目前）仍然致力于一个公共资助的医疗保健系统，在使用点基本上是免费的，政府希望鼓励更大的多样性，在提供医疗服务，包括一个更大的作用，为营利性私营部门。尽管其提案遭到强烈反对，但几乎没有做出让步，2012年3月通过的法规基本上保持不变。尽管缺乏令人信服的证据，但政府仍坚持鼓励更多的竞争和选择。那些认为这些变化将远远低于其设计者所希望的人过于自满，忽视了政府意识形态信念的力量。这些威胁将拆除NHS，取而代之的是一个更昂贵、更分散、更低效的医疗体系，该体系由利润驱动，而不是公共利益。
The British National Health Service (NHS) is undergoing possibly the most far-reaching set of changes in its sixty-five-year history. While some commentators (like Rudolf Klein) insist that little of substance is likely to change, others consider that the politics of reform may prove quite different on this occasion. The coalition government is committed to restructuring the welfare state and public services and to rolling back the state. The NHS as a popular monopoly public service runs counter to its neoliberal ideology. While (for now) remaining committed to a publicly funded system of health care that is largely free at point of use, the government wishes to encourage much greater diversity in the provision of care, including a much larger role for the for-profit private sector. Despite significant opposition to its proposals, few concessions have been forthcoming, and the legislation that passed onto the statute book in March 2012 remained essentially unchanged. Notwithstanding the lack of convincing evidence, the government is wedded to encouraging greater competition and choice. Thosewho believe the changes will amount to far less than its architects hope for are being too complacent and overlooking the strength of the government's ideological convictions. These threaten to dismantle the NHS and replace it with a more costly, fragmented, and less effective system of care that is driven by profit in place of the public interest.