AN ANALYSIS ON FUNCTIONS OF NONPROFIT ORGANIZATIONS IN HEALTH CARE SYSTEM OF USA

在这项研究中，我们报告了许多非营利性组织(NPO)在美国医疗保健系统中发挥着重要作用。他们是美国主要的卫生保健服务提供者，是社区的安全卫士，是解决贫困、健康、医疗体系中存在的一些混乱等问题的倡导者。此外，在美国的医疗保健系统和非营利部门中，还有一些经济上的大组织和许多草根的小组织。这一部门具有经济上的两面性，这也反映了大组织和小组织在美国医疗体系中发挥的作用的差异。具体地说，组织的规模对职业在组织化中的作用有着重要的影响。也就是说，在大型组织中，专业人员只在部门中扮演有限的角色，或者作为专家促进专业化。而在基层小社区中，他们不仅在整个活动中起着协调作用，而且在发展和满足社区需求方面发挥着主要作用，另一个结果是他们的使命离不开政府的支持。今天，随着管理式医疗在全国范围内普及，美国医疗行业非营利性和营利性之间的激烈竞争正在加剧。另一方面，联邦政府承诺削减对非营利组织的支持。在这种情况下，一些非营利组织，特别是大型非营利组织，正在从非营利组织向营利性组织转变。同时，基层小型非营利组织也面临着严峻的形势，尽管他们正在努力完成这一条件下的使命。在这里，他们的行动也反映了这种欺骗性。

In this study, we report that many nonprofit organizations (NPOs) play an important role in the US health care system. They are major providers of health care services in USA,safety guards in community, and are advocates to solve the problems such as poors, wellness, some confricts existing in health care system, and so on. Furthermore there are a few economically large organizations and a lot of grass-roots small organizations in the US health care system as well as the US nonprofit sector. This sector has ecomonical duplicity and this also reflects the difference in functions which large and small organizations play in the US health care system. Specifically, the scale of organizations has an important effect on the role which professions play in the orgarlization. That is, in the large organizations, the professions are filling only the limited role in the division or promoting the specialization as a specialist. While, in the grass-root small ones, they are playing the main role not only in coordinating in the entire of activity but developing and meeting needs of the communities.Another result is that they can not accomplish their mission without govemment supports. Today, as a managed care is pervading around the nation, a keen competition between nonprofit and for-profit is increasing in the US health care industry. On the other hand, federal government undertakes to cut the support for NPOs. Under this condition some of the NPOs, especially the large NPOs, are converting from nonprofit to for-profit. Also, the grass-roots small NPOs are confronted with a critical situation though they are making efforts to acomplish their mission under this condition. Here, also, their action reflects that duplicity.