Accounting and the ‘Insoluble’ Problem of Health-Care Costs
用福柯谱系学方法，考察1948年英国国民健康服务体系建立后医疗支出担忧的出现，论证医疗成本问题并非人口与技术变化的必然结果，而是历史偶然的，会计实践既构成也反映了这种担忧。
Health service accounting reforms are frequently promoted, explained or justified with reference to aging populations, expensive medical technologies and their purported implications for the cost of health care. Drawing on Foucault’s genealogical method, we examine the emergence of concerns regarding health expenditure in the wake of the creation of the British National Health Service in 1948, and their relationship with health service accounting practices. We argue that concerns regarding the cost of health care are historically contingent rather than inescapable consequences of demographic and technological change, and that health service accounting practices are both constitutive and reflective of such concerns. We conclude by relating our analysis to current attempts to control costs and increase efficiency in the health services.