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1980年7月,我曾在《新英格兰医学杂志》上撰写过一篇论文,支持在提高医护质量的同时,对节制医护费用开支的有效方法——医疗技术——进行评价。我认为我们需要一个大规模的全国性新方案,以支持对各类现有的和有待发展的医疗程序进行评价。这项工作将大多在私人医院进行,因此,需要大笔的经济资助……。建议所有第三方支付人把年支出额的一小部分用于资助该项方案。我还认为,新成立的全国卫生保健技术中心(NCHCT)对于联邦政府在这方面的致力资助可能是一个理想场所。但是,未着重指出:私人保险公司将如何使技术评价条理化,或如何使这些尝试与联邦政府的计划协调一致。自那以后,政府从联邦预算法案中把对全国卫生保健技术中心的经济资助减少为零。尽管该组织对费用节约方面大有潜力可挖,但是,很明显,它在政府部门几乎失去了所有的朋友,而且看来在近期内复兴的希望也非常渺茫。然而全国技术——评价方案的计划仍未失去其
In July 1980, I wrote a paper in the New England Journal of Medicine to support the evaluation of the effective method of spending on health care costs, medical technology, while improving the quality of health care. I think we need a large-scale national new program to support the evaluation of various existing and pending medical procedures. Most of this work will be carried out in private hospitals. Therefore, a large amount of financial assistance is needed... It is recommended that all third-party payers use a small portion of the annual expenditure to fund the program. I also believe that the newly established National Health Care Technology Center (NCHCT) may be an ideal venue for the federal government’s dedication in this area. However, it has not been emphasized how private insurance companies will organize technical evaluations or how they can be coordinated with the federal government’s plans. Since then, the government has reduced its financial aid to the National Health Technology Center from the federal budget bill to zero. Although the organization has great potential for cost savings, it is clear that it has lost almost all its friends in the government sector, and it seems that the hope of revival in the near future is also very slim. However, the national technology-evaluation program’s plan has not lost its