Zusammenfassung
In nahezu allen industrialisierten Ländern gelangen Reformen des Gesundheitssystems immer dann auf die politische Agenda, wenn die Ausgaben für diesen Bereich als zu hoch erachtet werden. Länderübergreifend werden für Kostensteigerungen der Zuwachs des Anteils Älterer an der Gesamtbevölkerung, die Vielzahl kostenintensiver technischer und pharmazeutischer Inventionen, eine gestiegene Nachfrage nach Gesundheitsleistungen sowie die Arbeitsintensität der Gesundheitsindustrie verantwortlich gemacht; darüberhinaus sind Ursachen in der internen Struktur des zu betrachtenden Systems zu suchen. In den Vereinigten Staaten, die sowohl in den Ausgaben für Gesundheitsversorgung als auch in der Zuwachsrate dieses Sektors Spitzenreiter sind, ist eine Gesundheitsreform seit Anfang der 1990er Jahre wieder in das politische Blickfeld gerückt. Neben dem Kostenfaktor sehen sich die USA dem Problem gegenübergestellt, daß aufgrund des Fehlens einer universellen Krankenversicherungspflicht ein Teil der Bevölkerung über keine Absicherung für den Krankheitsfall verfügt und sich diese Unsicherheit in zunehmendem Umfang auch in mittlere Einkommensgruppen erstreckt. Die Pläne zur Neustrukturierung des Gesundheitssystems haben die in den USA unbeantwortete Frage wieder zur Diskussion gestellt, ob die Absicherung gegen Krankheitsfolgen ein wesentliches soziales Gut ist, das für alle Bürger zur Verfügung stehen sollte.
“Each health system is the product of two cultures — the particular culture of each nation and the universal medical culture of technology.”
(Mark G. Field)
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Sattler, C. (1994). Das Gesundheitssystem in den USA — Geschichte, Entwicklung und Reformdiskussion. In: Blanke, B. (eds) Krankheit und Gemeinwohl. Reihe Gesellschaftspolitik und Staatstätigkeit, vol 5. VS Verlag für Sozialwissenschaften. https://doi.org/10.1007/978-3-322-95963-8_6
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