{"title":"关税冲突与既得利益:美国医疗改革僵局加深。","authors":"Miao Wang","doi":"10.1007/s10728-025-00542-1","DOIUrl":null,"url":null,"abstract":"<p><p>The US healthcare system is characterized by a persistent deadlock, where high costs, low efficiency, and inequity resist fundamental reform. This stalemate is rooted in deep ideological divides, political polarization, a fragmented fiscal structure, and the power of entrenched interest groups. This article analyzes how recent trade protectionist policies, specifically tariffs on pharmaceuticals and their inputs, intersect with this domestic gridlock. It posits a central paradox: a political system incapable of enacting major domestic health reform can simultaneously deploy assertive trade interventions in the same sector. The article argues that these tariffs should not be misconstrued as flawed instruments of healthcare reform. Instead, they represent the application of a distinct sovereigntist and protectionist logic, driven by national security concerns. The consequence is not a failed attempt at a solution, but a collision of policy agendas that actively exacerbates the healthcare system's core dysfunctions. By increasing costs, destabilizing supply chains, and creating new arenas for interest group conflict, tariffs intensify partisan strife and further entrench the reform deadlock. This process, marked by the \"securitization\" of the pharmaceutical industry, signals a critical shift in global health governance, where geopolitical strategy now overrides and complicates the pursuit of domestic public health goals.</p>","PeriodicalId":46740,"journal":{"name":"Health Care Analysis","volume":" ","pages":""},"PeriodicalIF":1.6000,"publicationDate":"2025-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Tariff Conflicts and Entrenched Interests: The Deepening Deadlock of US Healthcare Reform.\",\"authors\":\"Miao Wang\",\"doi\":\"10.1007/s10728-025-00542-1\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><p>The US healthcare system is characterized by a persistent deadlock, where high costs, low efficiency, and inequity resist fundamental reform. This stalemate is rooted in deep ideological divides, political polarization, a fragmented fiscal structure, and the power of entrenched interest groups. This article analyzes how recent trade protectionist policies, specifically tariffs on pharmaceuticals and their inputs, intersect with this domestic gridlock. It posits a central paradox: a political system incapable of enacting major domestic health reform can simultaneously deploy assertive trade interventions in the same sector. The article argues that these tariffs should not be misconstrued as flawed instruments of healthcare reform. Instead, they represent the application of a distinct sovereigntist and protectionist logic, driven by national security concerns. The consequence is not a failed attempt at a solution, but a collision of policy agendas that actively exacerbates the healthcare system's core dysfunctions. By increasing costs, destabilizing supply chains, and creating new arenas for interest group conflict, tariffs intensify partisan strife and further entrench the reform deadlock. This process, marked by the \\\"securitization\\\" of the pharmaceutical industry, signals a critical shift in global health governance, where geopolitical strategy now overrides and complicates the pursuit of domestic public health goals.</p>\",\"PeriodicalId\":46740,\"journal\":{\"name\":\"Health Care Analysis\",\"volume\":\" \",\"pages\":\"\"},\"PeriodicalIF\":1.6000,\"publicationDate\":\"2025-09-10\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Health Care Analysis\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1007/s10728-025-00542-1\",\"RegionNum\":3,\"RegionCategory\":\"哲学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q2\",\"JCRName\":\"ETHICS\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Health Care Analysis","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1007/s10728-025-00542-1","RegionNum":3,"RegionCategory":"哲学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"ETHICS","Score":null,"Total":0}
Tariff Conflicts and Entrenched Interests: The Deepening Deadlock of US Healthcare Reform.
The US healthcare system is characterized by a persistent deadlock, where high costs, low efficiency, and inequity resist fundamental reform. This stalemate is rooted in deep ideological divides, political polarization, a fragmented fiscal structure, and the power of entrenched interest groups. This article analyzes how recent trade protectionist policies, specifically tariffs on pharmaceuticals and their inputs, intersect with this domestic gridlock. It posits a central paradox: a political system incapable of enacting major domestic health reform can simultaneously deploy assertive trade interventions in the same sector. The article argues that these tariffs should not be misconstrued as flawed instruments of healthcare reform. Instead, they represent the application of a distinct sovereigntist and protectionist logic, driven by national security concerns. The consequence is not a failed attempt at a solution, but a collision of policy agendas that actively exacerbates the healthcare system's core dysfunctions. By increasing costs, destabilizing supply chains, and creating new arenas for interest group conflict, tariffs intensify partisan strife and further entrench the reform deadlock. This process, marked by the "securitization" of the pharmaceutical industry, signals a critical shift in global health governance, where geopolitical strategy now overrides and complicates the pursuit of domestic public health goals.
期刊介绍:
Health Care Analysis is a journal that promotes dialogue and debate about conceptual and normative issues related to health and health care, including health systems, healthcare provision, health law, public policy and health, professional health practice, health services organization and decision-making, and health-related education at all levels of clinical medicine, public health and global health. Health Care Analysis seeks to support the conversation between philosophy and policy, in particular illustrating the importance of conceptual and normative analysis to health policy, practice and research. As such, papers accepted for publication are likely to analyse philosophical questions related to health, health care or health policy that focus on one or more of the following: aims or ends, theories, frameworks, concepts, principles, values or ideology. All styles of theoretical analysis are welcome providing that they illuminate conceptual or normative issues and encourage debate between those interested in health, philosophy and policy. Papers must be rigorous, but should strive for accessibility – with care being taken to ensure that their arguments and implications are plain to a broad academic and international audience. In addition to purely theoretical papers, papers grounded in empirical research or case-studies are very welcome so long as they explore the conceptual or normative implications of such work. Authors are encouraged, where possible, to have regard to the social contexts of the issues they are discussing, and all authors should ensure that they indicate the ‘real world’ implications of their work. Health Care Analysis publishes contributions from philosophers, lawyers, social scientists, healthcare educators, healthcare professionals and administrators, and other health-related academics and policy analysts.