The Turn to the Local
本文指出美国医疗体系的核心问题是合法性缺失，提出将医疗地方化（类似公立学校模式）以解决私人保险困境、控制成本并保留先进医疗技术，为政策制定者和研究者提供新思路。
It is not too early to suggest that the attempts to place medical care in private hands (through group insurance arrangements) has not fulfilled its promise—or better, the promises that were made for it. Yet history has not been kind to plans to make government the single payer, and the laudable progress in medical technology has placed high-technology medical care beyond the reach of most private budgets. In this paper I suggest that the major problem of the U.S. health care system as presently conceived is a failure of legitimacy, and I put forward a proposal that purports to solve that problem. The proposal is to localize health care, on the model of a public school system, on the argument that such localization will answer most of the questions of legitimacy at the core of the private insurance imbroglio, provide a brake for medical costs, while preserving our ability to take advantage of the most advanced medical interventions. I present some initial arguments for the proposal, but await its proof in the dialogue emerging as the present insurance system collapses.