美国围绕《1939年国家健康法》的争议与结果探析

The Controversy and Results of the National Health Act of 1939 in the U.S.

20世纪初,妇女组织推动美国颁布保护妇幼健康权益的相关法案并取得一定成效。1935年,美国开始现代福利国家建设,全国性健康法迎来立法契机。联邦政府对全国性健康立法进行实质性干预,拥有前期立法基础的妇幼保健问题成为此次立法的关键抓手,从妇幼保健角度出发设立《国家健康法》的必要性和迫切性得到美国社会的普遍认同。然而,具体的立法方案遭到美国医学协会的反对。《1939年国家健康法》在美国社会引起争议,其实质是医疗资源分配和社会改革之间的冲突,也是医疗的社会性因素和病理性因素之间矛盾的体现。《1939年国家健康法》的立法虽然失败,却成为联邦政府主动处理医疗与社会两者关系的开端并为后来美国的福利国家建设打下了基础。

In the early 20th century,women's organizations pushed the United States to enact laws to protect the rights and interests of maternal and child health and had made some achievements.In 1935,the United States aimed at building a modern welfare state,the National Health Act was thus given a chance to set up.The federal government made substantial intervention in the national health legislation,and the maternal and child health care was in the spotlight.The necessity and urgency of establishing the National Health Act of 1939 for the purpose of maternal and child health had been widely recognized by the American society.However,the legislative proposalwas opposed by the American Medical Association.In essence,it was a conflict between the distribution of medical resourcesand social reform,as well as an embodiment of the contradiction between the social and pathological factors of medical treatment.Although the National Health Act of 1939 failed,the U.S.government began to take the initiative to deal with the relationship between medical treatment and society,and the legislation played a fundamental role in the building of the American welfare state.