健康与政治经济学:在美国建立新的常识。

Health affairs scholar Pub Date : 2024-05-06 eCollection Date: 2024-05-01 DOI:10.1093/haschl/qxae041
Victor Roy, Darrick Hamilton, Dave A Chokshi
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引用次数: 0

摘要

近几十年来,以自由市场思维和个人主义文化叙事为特征的主流经济范式深深地影响着当代社会,包括美国的卫生事业。这种范式绝非自然形成,而是与政治、社会群体分层和规范反复交织在一起,共同形成了所谓的政治经济学。其后果在健康领域体现得淋漓尽致,美国每年有数百万人过早地失去了生命。借鉴气候和法律等领域的经济反思,我们主张建立一种新的 "常识",即以健康为中心的政治经济学。这一转变的核心是在三个相互关联的领域采取行动:资本、护理和文化。调整资本的方向,优先考虑长期投资,如对医疗保健和婴儿债券的公共选择,可以促进健康,并肯定历史上被边缘化的群体。认识到护理工作的经济价值和对健康的必要性,美国各地的社区保健工作者骨干等方法将成为建设强大护理基础设施的一部分。反过来,要推动这些方向的发展势头,就必须改变主流文化的叙事方式。在卫生领域面对现实障碍寻求变革的过程中,近期重振产业政策和解决集中市场力量的努力可以起到启发作用。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Health and political economy: building a new common sense in the United States.

The prevailing economic paradigm, characterized by free market thinking and individualistic cultural narratives, has deeply influenced contemporary society in recent decades, including health in the United States. This paradigm, far from being natural, is iteratively intertwined with politics, social group stratification, and norms, together shaping what is known as political economy. The consequences are starkly evident in health, with millions of lives prematurely lost annually in the United States. Drawing on economic re-thinking happening in fields like climate and law, we argue for a new "common sense" towards a health-focused political economy. Central to this proposed shift is action in 3 interconnected areas: capital, care, and culture. Re-orienting capital to prioritize longer-term investments, such as in public options for health care and baby bonds, can promote health and affirmatively include historically marginalized groups. Recognizing that caregiving is economically valuable and necessary for health, approaches like local cadres of community health workers across the United States would be part of building robust caregiving infrastructures. Advancing momentum in these directions, in turn, will require displacing dominant cultural narratives. As the health arena pursues change in the face of real obstacles, recent efforts reinvigorating industrial policy and addressing concentrated market power can serve as inspiration.

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