关税冲突与既得利益:美国医疗改革僵局加深。

IF 1.6 3区 哲学 Q2 ETHICS
Miao Wang
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引用次数: 0

摘要

美国医疗体系的特点是持续僵局,高成本、低效率和不平等阻碍了根本改革。这种僵局的根源在于深刻的意识形态分歧、政治两极分化、支离破碎的财政结构和根深蒂固的利益集团的权力。本文分析了最近的贸易保护主义政策,特别是对药品及其投入的关税,是如何与这种国内僵局相交叉的。它提出了一个核心悖论:一个无法实施重大国内医疗改革的政治体系,可以同时在同一部门实施强硬的贸易干预。文章认为,这些关税不应被误解为有缺陷的医疗改革工具。相反,它们代表了一种独特的主权主义和保护主义逻辑的应用,这种逻辑是由国家安全担忧驱动的。其结果不是解决方案的尝试失败,而是政策议程的碰撞,积极地加剧了医疗体系的核心功能失调。关税增加了成本,破坏了供应链的稳定,为利益集团冲突创造了新的舞台,加剧了党派冲突,进一步加剧了改革僵局。以制药业“证券化”为标志的这一进程标志着全球卫生治理的重大转变,地缘政治战略现在压倒国内公共卫生目标,并使其复杂化。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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.

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来源期刊
CiteScore
4.20
自引率
0.00%
发文量
3
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.
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