歯1996110502.PDF

1, 3 1. 3 2. 5 3. 6 4. 7 2 11 1. 11 2. 16 3. 25 4. 27 5. 42 3 45 1. 45 2. 50 3. 59

4 63 1. 63 2. 66 3. 74 4. 86 5. 120 5 139 1. 139 2. 143 3. 171 4. 199 5. 206 6. 215 6 237 1. 238 2. 246 255

2 < 2-1> 22 < 2-2> 22 < 2-3> ( / ) 23 < 2-4> ( ) 29 < 2-5> ( ) 30 < 2-6> GNP 30 < 2-7> 31 < 2-8> 33 < 2-9> 35 < 2-10> 38 3 < 3-1> 45 < 3-2> 3 (, ) 46 < 3-3> ( ) 47 < 3-4> (1995 ) 49 < 3-5> (1996) 51 < 3-6> (1996) 52 < 3-7> 53 < 3-8> (1996) 54 < 3-9> (95 ) 55 < 3-10> (96 ) 55 < 3-11>,, (1996) 56 < 3-12> (1996) 57

4 < 4-1> 75 < 4-2> 76 < 4-3> 79 < 4-4> 79 < 4-5> : 1996 79 < 4-6> 80 < 4-7> : 1996 83 < 4-8> 87 < 4-9> : 1 87 < 4-10> 88 < 4-11> 88 < 4-12> : 1992-1996 91 < 4-13> : 91 < 4-14> 1995 ( ) 93 < 4-15> : 1995 95 < 4-16> 100 < 4-17> 101 < 4-18> 1996 103 < 4-19> 104 < 4-20> 108 < 4-21> 108 < 4-22> 110 < 4-23> 113 < 4-24> 114 < 4-25> : 1995 115 < 4-26> 123

5 < 5-1> 144 < 5-2> 145 < 5-3> 146 < 5-4> (1996 ) 146 < 5-5> 148 < 5-6> 148 < 5-7> 149 < 5-8> 150 < 5-9> : 1985 1993 151 < 5-10> OECD 1 (G ) (NHE ) 153 < 5-11> 154 < 5-12> 154 < 5-13> 155 < 5-14> (1994 ) 156 < 5-15> 157 < 5-16> 159 < 5-17> 159 < 5-18> 160 < 5-19> 161 < 5-20> ( ) 163 < 5-21> 165 < 5-22> (1996 ) 166 < 5-23> 166 < 5-24> 167 < 5-25> 167 < 5-26> 1 168 < 5-27> 172 < 5-28> 173 < 5-29> 174

< 5-30> 175 < 5-31> (1996 ) 179 < 5-32> 180 < 5-33> (1995 ) 181 < 5-34> 184 < 5-35> 187 < 5-36> 189 < 5-37> 190 < 5-38> 191 < 5-39> 193 < 5-40> 193 < 5-41> ( ) 194 < 5-42> 196 < 5-43> 196 < 5-44> 200 < 5-45> 200 < 5-46> (1995 ) 201 < 5-47> 202 < 5-48> (1995 ) 205 < 5-49> 206 < 5-50> ( ) 208 < 5-51> 208 < 5-52> 215 < 5-53> ( ) 223 < 5-54> ( ) 223 < 5-55> 227

4 < 4-1> 81 < 4-2> 84 5 < 5-1> 141 < 5-2> 164 < 5-3> 170 < 5-4> 176 < 5-5> (1996 ) 177 < 5-6> (1996 ) 178 < 5-7> 199 < 5-8> 218 < 5-9> 228

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2 2 1., (functional definition ). 1.1 ( ) (w elfare)...,.. (social welfare)., (,,,, ), (,,, ) (,, ) (,, ).,. (per sonal welfare),...1) 1),., (Rawls, 1971). 11

,.,.,,. (system of social w elfare programs ). 2.2),...3 ), ( ).. 4),.. 5) 2) 2, (residual).,. (institutional),. ( ),. (Compton, 1980, p. 26). 3) (B. R. Compton) (interstitial institution). (Compton, 1980, p. 31). 4),,,. 5) Rimlinger (1971). 12

2.., ( ) (, ; public social w elfare service),, (, ; private social w elfare service).,... 1.2 ( ) (national minimum ) (basic needs),,,,,, ( ; social security system ). 6). (social insurance) (public assistance) (social welfare service).,,,,,.7),,,, 6),,,,. (, 3 1 ). 7) 3 1,,,,,, ( 3 5 )..,. 13

. 8),. 9).,,,,.10)..,.,.. 11).. (w elfare state)12) 8). (, 3 2 ). 9). (, 3 3 ). 10). 3 4. 11) (Heinz Lampert),,,,,,,,,, (Lampert, 1991,, p. 23).. 12),,.,,, (national minimum)..,. 14

2.,,..,. 80. 15

2.,.,,,. 2.1 1) ( ).,.. 60 30..13),,.. 19,,, 2 3, 60. 13) (mercantilism), (Walter Eucken ) (Zentralverw altungsw irtschaft).. (Eucken, 1952, p. 118).... 60. (1908-50) (Ordnung Liberalismus). 16

2,,,, 30 3........ ( ). 14 ),,,,. ( ) 15).... 14), (mercantilism ; interventionism) (liberalism). 16 18. 19 1930, 1970 ( ), 1980 ( )., ( ). 15)......,. (economic process) (economic order). (Eucken, 1952). 1 7

..,..,,,.....,,..,. (100 )..,. ( )...... 18

2....... ( ).,,,,, ( ). (1996),,..,.... 2 (Wilhelm Röpke),,,, (Röpke, 1960, p. 175)...,,... 19

, (security ). ( ) (Buchanan, 1975, pp. 78-9). ( ) ( ).. 2 ) 30,.... 30. 80 90.. 90.. 3 )...,,,,, 2 0

2,.,... 80. 60 80.,,...,..... 2.2.. 1) 2 1

. < 2-1> 1995 72.9 2020 77.0, 8.0% 17.5%.. < 2-1> 1995 2000 20 10 2020 ( ) 72.9 74.3 76.1 77.0 1 ) (% ) 8.0 9.4 13.1 17.5 : 1) 65 15 64. : (1996), 21, p. 16. 2 ),. < 2-2>,, 1995 52% 2020 76%.,,. < 2-2> 1995 2000 2020 ( =100) 52.1 1 ) 60.2 2 ) 76.3 3 ) 1) 1994 2) 1992 GNP 12,000 15,000 3) 1992 5, 21,, p. 6. 3 ) 1970 41.1% 90 74.4%, 22

2 2000 80.6% (< 2-3> )..,,.. < 2-3> ( / ) ( : %) 1970 1980 1990 2000 41.1 57.3 74.4 80.6 : (1996), 96, p. 149., 16 ).,,.... 4 ),,,,,,,,. 16) (urban informal sector).,,,.. 2 3

. 2.3..,.,...,.......,.,,...,,....17 ) 17) (, 1995, pp. 71-2). 24

2 3. 95 7 35...,,,.. (, ),......,,.,.... 18), 18) (1995). 25

,...,..,.,.,., (, )...,....., (, 1995, p. 72). 2 6

4. 2 4.1 80.. 5.16 3,.,,,,,,,, 60... 70. 72 10. 70. 76 500,. 73. 77 500. 79, 300. 80 5. 60 3. 81,, 83.. 80 2 7

. 63, 66 20 82 84. 82 12. 6 87. 87, 88,, 10, 5,,. 89, 90, 91. 92 5, 93. 94, 95,., < 2-4>,,,,, 4,,. 4.2.. < 2-5>, 1985 4,005 1990 1 4968. 80. 90 5.5% 6% 1996 3 5,245. 1%. 28

2 < 2-4> ( ), 1988, 1960, 1975 1963, 1977, 1988 1979 1964 1995 1984 1977 1962* 1962*,, 1961* 1981* 1981* 1986* 1) * : : 1),,,,. 2 9

< 2-5> ( ) ( :,%) 1985 1990 1994 1995 1996 (A ) (B) (C) 1 ) C/ B C/ A 793,011 124,064 4,005 3.2 0.51 1,782,621 274,637 14,968 5.5 0.84 3,059,702 432,500 26,129 6.0 0.85 3,512,948 518,811 29,245 5.6 0.83-579,621 35,245 6.1 - : 1),,,, ( ),. :, 1995, pp. 90-3. ; 1996, pp. 20-27. < 2-6> GNP ( ) ( : %) 1989 22 * 1993 22 * 5.3 11.2 6.1 10.6 1.1 3.0 1.4 2.5 0.3 1.7 0.2 1.7 3.8 6.5 4.3 6.4 * :,,,,,,,,,,,,,,,,,,,,,. : (1995),. ( ).. p. 273. (GNP) < 2-6>.., 1993, 22 GNP 2.5%, 10.6% 1.4% 6.1%... < 2-7>, 92 30

2 (, ), 36.8% ( 30.0%, 6.8%), 54.1% ( 23.0%, 31.1%), ( ) 9.7%.. 88 35.6% 92 30.0%. 93 95 ( ), 93. < 2-7> ( : 10, %) 1986 1988 1990 1992 1 ) 491 (21.1) 759 (18.7) 1,294 (19.1) 1,808 (18.0) 337 (14.5) 530 (13.1) 883 (11.1) 1,208 (12.0) 829 (35.6) 1,289 (31.8) 2,177 (32.2) 3,017 (30.0) 138 (5.9) 229 (5.7) 503 (7.4) 682 (6.8) 536 (23.1) 1,021 (25.2) 1,454 (21.5) 2,306 (23.0) 696 (29.9) 1,300 (32.1) 2,233 (33.0) 3,126 (31.1) 2 ) 126 (5.4) 213 (5.3) 418 (6.2) 977 (9.7) 2,325 (100.0) 4,051 (100.0) 6,768 (100.1) 10,062 (100.0) 1) 2) (1994),.., p. 102. 4.3,...,,,,.. 31

,,,,.,. 89,.,, 5, 94 61.5%..... 30% (96 ),. 53%. 80% (, 1994, p. 102)., 3.8% (174 ), 1 1.3% (61 ),...... (1995, p. 51), 5%, 15%.,, (,,,,, ). 19)(, 1995, p. 23). 32

2,,. 2 2,.,.,... 1989, 64.5%, 62.7% (, 1989). < 2-8>. < 2-8>,,, 196 1 1962-72 1973-87 1987 * * * * * ** ** ** ** ** * * * * * * ** ** ** ** ** ** ** ** ** ** ** * * * * : ** : : (1995), p. 33. 19)., (, 1995, p. 24 ). 33

,, 60, 87.. ( ),,.,,,,,.. 20),.. 84,. 1996, 296, 76, 1,134, 1,506 3.3%..,., 21),, 22)., ( 23 ) )., ( ), 20).. 21), 65, 15,,. 22) 1996, 20, 2,500, 21, 2,700. 23) 21), 65, 15,,. 34

2, ( ). 96 10 7. ( 1 ).. 5 (1994) 94 166,671, 149,353.,, 96 107,000.,. < 2-9> 90 5.4% 96 3.3%.. 3.3%. ( ) 7%.24) 96 3.3%. < 2-9> ( :, %) (A ) (B) A/ B 1990 199 1 1992 1993 1994 1995 1996 2,256 2,246 2,176 2,001 1,902 1,755 1,506 42,869 43,268 43,663 44,056 44,453 4,485 45,820 5.4 5.2 5.0 4.5 4.3 3.9 3.3 :, 1995 96 24) 5 94 178, 94 18.9%.. 1994 ( ), 5.04%. 6.2%, 13.49%, 7.5%. 94 4 649.6, 612.1, 553, (, 1990, pp. 178-9). 35

4.4...,,.,,.,,. 25),,,...... 95 105 38. 5 3 ( 22, 31 ) 5%., 19 3 1.,, ( ). 1995 1,021,,, 30% 294. 4.5,. 25),,,, ( ). 36

2.. 1), (, 1993, p. 37).. < 2-4>,,,,,,,.,..,.,,, (, 1995).,,,,.. 2 )... 15, 25 30. 3 7

3 ).,,.,,... 94 4,,,,. ( ) 9, 15...,, ( ). 1988-90 1991 1992 1993 1994 1995 < 2-10> ( :, %) 21,987 46.3 53.7 0.0 11,288 44.3 45.1 10.6 14,229 42.9 48.7 8.4 28,614 33.3 61.5 5.2 37,439 92.7 4.8 2.5 45,996 84.4 12.4 3.2 : (1995b), 1995, p. 289. < 2-10>, 93 94 4.8%, 95 12.4%, 93 ( 38

2 ) 94 92.7%, 95 84.4%. 94..,.....,.........,.,,,,,.,....,.,, 5% 39

, 10%.. 4 ).., ( ).. (national minimum )...,.,,. 5 ).,,,,.. 1-2.,.,,.,, 4 0

2.,.. 91 95 3,000. 7-8, 6. 41

5.,,.. (1) :. (2) :,,,,.,,,,,,. (3) :,,,,,.,.,.,,... 42

3 3 ( ).,. 43

3 3 1.. 1995 7 1.. ( ),, 7. 1),,,,, < 3-1> 1995 1996 ( :, %) 38,136 100.0 44,416 100.0 16.5 1 ) ( ) 2 ) 3 ) 1,449 11,150 (2,204) 14,916 1,391 9,230 3.8 29.2 (5.8) 39.1 3.6 24.2 2,458 16,056 2,979 13,626 1,947 10,329 : 1),,, 2),,, 3),, : (1996c), 1996, p. 28. 5.5 36.1 6.7 30.7 4.4 23.3 69.7 44.0 35.1-8.7 40.0 11.9 1),,,,,,. 45

.. < 3-1>. 1995 96, (,,, ), 1 4,916 (39.1%) 1 3,626 (30.7%), (,,, ) 1 1,150 (29.2%) 1 6,056 (36.1%). 95 96., 1995 2,204 (5.8%) 1996 2,979 (6.7%) 35.1%. < 3-2> 3 (, ) 1995 3 ( :, %) 1996 1997 1998 72,453 100.0 70,491 100.0 81,035 100.0 84,091 100.0 235,617 100.0 3,464 10,996, 23,701, 3,027 5,604, 14,312, 11,349 4.8 15.2 32.7 4.2 7.7 19.7 15.7 5,265 14,132 21,928 3,784 5,743 6,513 13,126 7.5 20.0 31.1 5.4 8.2 9.2 18.6 6,745 17,050 23,931 5,097 6,645 8,154 13,413 : (1996c), 1996, p. 31. 8.3 21.0 29.5 6.3 8.2 10.1 16.6 6,856 18,741 24,773 5,221 6,895 7,676 13,929 8.2 22.3 29.4 6.2 8.2 9.1 16.6 18,866 49,923 70,632 14,102 19,283 22,343 40,468 8.0 21.2 30.0 6.0 8.2 9.5 17.1 < 3-2>. 96 3 2), ( ) 96 5.4%, 97 6.3%, 98 6.2%. 95 4.2% 2%. 95 96 ( ),,. 2).. 4 6

< 3-3> ( 1 ) ) 3 ( :, %) 2 ) 3 ) ( ) 4 ) 1995 18,981 29,076 50,441 2,678 47,754 614 33,605 25,589 8,542 6,540 12,380 243,170 5 ) 5.7 1996 (A ) (B ) B/ A 26,481( 8.2) 35,065(10.9) 55,410(17.2) 3,579( 1.1) 48,538( 15.1) 705( 0.2) 58,971(18.3) 37,766(11.8) 10,035( 3.1) 7,741( 2.4) 26,879( 8.4) 321,402(100.0) 6.7 447 12,037 21,793 490 23,542 194 5,916 13,205 2,190 1,251 4,683 1.7 34.3 39.3 13.7 48.5 3.6 10.9 35.0 21.8 16.2 17.4 85,788 26.7 : 1). 2),,,, 3) 4) 5) (1995 2,203, 1996 2,979 ). : (1996d), 1996. < 3-3>. 3),.4) 96 3,214 2,432 32.2%. 1996, 590 3) (,,, )...,. 4).. 90 38.8% 48.5%. 50%. 4 7

(18.3%), ( ) 554 (17.2%), 485 (15.5% ), ( ) 378 (11.8%), 351 (10.9%), 2,358 (73.3%).. 1996 3,214 858 (26.7%). 70%..., (36 1 3 ), 50%, 20%, 10% (36 1 4 ).,,,. (50% ). 60%. 96 ( ) 1,858 57.8%., 40%.,.. (,,, ),. 1995 344 (,, ) 10, 150, 173, 11, (< 3-4> )., 77, 75, 50, 49, (, ) 40 53. 48

3 < 3-4> (1995 ) ( )* ( ) 344 333 10 150 173 102,418 11,855 65,795 24,768 11 77 75 60 15 42,443 31,760 10,680 2 75 75 60 15 12,418 9,935 2,483 4 4 4 370 370 5 5 1 4 3,730 560 3,170 50 49 7 42 6,559 1,465 5,094 1 4 4 1 3 4,200 200 4,000 1 1 1 200 200 49 47 6 41 4,125 2,500 1,625 2 1 1 1 6 6 6 210 210 7 7 7 164 164 3 3 3 6,465 6,465 40 40 2 38 5,433 1,900 3,533 5 5 5 606 606 2 2 1 1 160 80 80 9 9 3 6 15,335 4,550 10,785 6 6 * :,, : (1996d), 1996, p. 174. 49

2. 2.1 5)...,,. 1990 180,218 1996 4 98,900 0.9%. 3.3% 1/ 3., 13,000 17,300, 27,000 73,400, 8,200 74%.6), 1,7),,, 2. 1996 < 3-5>. 102,467 8) 92,831 (91.9%) 8,150 (8.1% ).. 57%.,,,. 5) 4. 6). 96 (96. 1).. 7) 1, 2, 1 1,500 20% 10.. 8) < 3-5>,, 1996.. 5 0

3 < 3-5> (1996) ( ) ( ) ( ) 102,467 9 4, 3 1 7 13,807 8,169 2,141 13,417 4,067 1,569 1,347 49,800 8,150 473 5,000 292 2,385 43,631 43,631 9,205 4,084 0 6,800 0 23,542 0 0 0 0 0 0 0 107 1) 92 10Kg 1, 2,500, 180, 1,000 17,000,, : 1). : (1996d), 1996, pp. 176-7 ; (1996e),, p. 8. 2.2 95 225 2.2%. 59 26.2%. 6%, (, ) 82%, 12%.. < 3-6> 1996 36,480,9) 3,902 (10.7%), 735 (2.0%) 31,843 (87.3%). 20,492 (56.2% ) 6. 9) < 3-3>. 51

< 3-6> (1996) ( : ) 36,480(100.0) ( ) 3,902(10.7) 720( 2.0) 245( 0.7) 107( 0.3) 150( 0.4) 1,240( 3.4) 1,440( 3.9) 0 ( 0.) 4 6% 2 6% 400 ( ) 735( 2.0) 399( 1.1) 160( 0.4) 176( 0.5) 5 (17 ) 4 1 ( ) 31,843(87.3) 20,492(56.2) 5,372(14.7) 2,655( 7.3) 2,931( 8.0) 393(1.1) 46 5 3 37 1 (25 ) : (1996e),, pp. 11-12.,.. - : 4. - : ( 25 ). - :. - :,, - : 6% 1 - : 6% 2 52

3,,.. 4 1. 95 12 96 5 17. 6. 96 4. 96 5, 3, 37, 46. 96 5 48 27, 21. 4, 3, 1, 8, 9, 2. 6, 9, 2, 4. 2.3. < 3-7> 93 473 (4.2% ) 95 537 (5.0%), 2000 687 (6.3% ). < 3-7> ( :,%) 1993 1995 1997 2000 10,925(100.) 473(4.2) 5,435(49.7) 3,247(29.7) 78(0.7) 10,776(100.0) 537(5.0) 5,428(50.4) 2,994(27.7) 84(0.78) 10,789(100.0) 592(5.5) 5,364(49.8) 2,778(25.7) 90(0.83) 10,762(100.0) 687(6.3) 5,351(49.7) 2,612(24.2) 93(0.86) : (1996),, p. 6. < 3-8> 96 58,971. 33,605 75%,. 53

., 70 96 3 ( 2 ), 80 95 5 ( 1 5 ). 65, 65 12,240. < 3-8> (1996) ( : ) * 58,971 4,946 14 13,730 4,612 29,467 2,000 4,202 5,916 3,462 14 0 0 2,254 0 187 * :, : (1996d), 1996, pp. 178-9. 96.. 96 527 3 3,700. < 3-9> 95 1,773 1,888. 10, 707, 1,171. < 3-10> 96 115.,, 29,467 ( 2,254 ) 96. 54

< 3-9> (95 ) 3 1,888 10 707 1,171 7 2 5 6 2 4 3 2 1 7 2 5 7 2 5 1,773 706 1,067 85 85 : (1996),, p. 3 < 3-10> (96 ) 115 4 52 59 5 4 1 3 3 2 2 1 1 1 1 * 40 40 63 51 12 * : 4-5 ; 96. : (1996),, p. 3 2.4, ( ). 95 84, 83% 70 55

2,100 ( 404, 1696 ). 96 98 3 870 100%. < 3-11> 96 13,205 37,766 (835 ). (,, ). 96 14,456 ( 4,683 ) 54%. (7,950 ), (2,295 ), (2,136 ). < 3-11>,, (1996) ( : ) ( ), 1 ) ( ), 37,766 29,416 7,850 498 26,879 14,456 2,295 2.136 7,950 41 13,205 8,914 4,291 0 4,683 4,455 228 0 0 0 835 45 ( ) 2 ) 7,741 2,508 3,150 413 150 1,520 1,251 0 1,200 0 0 51 3 97 4 : 1) 2),, : (1996d), 1996, pp. 178-9. 5 6

3, 96 7,741. ( ) 2,508, 3,150 73%. 97 ( ), 4.,. 2.5 ( ) (,, ). 10),.. < 3-12> 96 2,439 ( 1,220 ), 388 ( 194 ), 3,624 ( 826 ).., 96 98 3 60. < 3-12> (1996) ( : ], * 10,740 2,439 388 3,624 2,619 219 1,000 451 2,384 1,220 194 826 144 0 0 0 9,272 26,514 13 8 : (1996d), 1996, p. 178, 180. 10) 4 972. 5 7

2.6 96 5 97 7 2,123 (344 )..,.,,,,,,,,,,. 58

3. 3 2 3,..,,,...,,,,.... 0.9%. 3.3%...,.....,,,, 59

..,,,.,. 1.,.,,... 7,..,.,,,,,.,.. 6. 2...,, (, 1994, pp. 159-162). 60

4 4 ( )..,.,,.,,.... 61

4 4 1.,,. 1. (public assistance)... 34 1 5,. 1961,. 1980 1982,.. (the pure needy ), (the able- bodied) (Murray, 1984 ;, 1995). 1). (, 1993, pp. 42-43 ;, 1994, pp. 68-73 ;, 1995, pp. 84-89 ; 1) 1. 63

, 1995, pp. 148-150)..,.,..,. (top- down) (bottom - up) (street - level bureaucracy ).,.,.,,.,...,,..., (2 ), (2 ), (2 ) (6 ) 12. (8 7 ).,.., 64

4..... 65

2....,., - -,.,.,. 2.1.. ( :, 1994 ;, 1995 ;, 1995).,., ( :, 1989 ;, 1991)...,. (1995) (1995), (1993).,. 66

4,,.,, (burnout ) ( :, 1990 ;, 1991) ( :, 1991 ;, 1994)... (middle- range).. 2.2 1) 1960 (Great Society ), (War on Poverty ).., 1970 (implementation studies) 2).. (Alexander, 1985 ; Williams, 1982).,. (top- down model), (bottom - up model)..,. Lowi, Montjoy O'T oole, Sabatier 2) Derthick (1972), Pressman & Wildavsky (1973), Hargrove(1975). 6 7

Mazmanian. Lowi(1969).,. Montjoy O 'T oole(1979). Sabatier Mazmanian (1980). 17,,. Elmore(1979) (forw ard mapping ).,.,..,,,,..,.. (unidirection).,,,, (Nakamur a & Smallw ood, 1980).. 3). Elmore(1979) 3), Bardach (1977)., (a series of games). Stone(1980) (implementation problem ),.. 68

4.,. (backward mapping )....,.,.,... (Sabatier, 1986).. Elmore (1979), (the source of the policy ),. (the source of the problem ),... 2 ) Van Meter & Van Horn (1975) Sabatier & Mazmanian (1980). Van 69

Meter Van Horn (1975),,,,, 6.. (enforcement activities ),,.,,. Sabatier Mazmanian (1980) 3 (, ), 17. (tractability of the problem ).,,,., (ability of statute to structure implementation ).,,,,,,.,,,,, (commitment ). 2.3 1) (street - level bureaucracy ) Lipsky (1980)., (Lipsky, 1980, p. 3). Prottas (1979, p. 2). 70

4.,. (Prottas, 1979 ; Lipsky, 1980 ;, 1990).,. (paper processing ) (people processing ). (face- to- face relations).,.,.,.. Burke(1987), Linder Peters (1987).,..,. 4 ),.,... 4) Lipsky (1980). 71

.. 2 ) :,,.,..,.,,,., (Lipsky, 1980, p. 15). (pp. 13-14).,,.,.., (Lipsky, 1980, pp. 15-16)..... 72

4..... (hard services) (soft services ). (Moore, 1987, pp. 90-92).. (, 1990, 1993 ;, 1993). 73

3. 3.1 1), 34.., (, 1995, p. 85)..... 3 65, 18,,., 5)., (, 1994, p. 68),,,,,, 3 (< 4-1> ).. 6).. 5) 3 1 5. (, 1995, p. 88). 6) (1995, pp. 88-89). 74

4 5 2, 6 1. < 4-1> ( 6 1 ) 65 18 50 ( 6 2 ) ( 6 3 ) ( ) : 7 6.. 1 ( ).. (, 1992, p. 172).,. (, 1995, p. 87). 75

< 4-2> 1961 1982 1987 - - - -,, - 1961 1984 - - 1961 1977 1986 1994 - -. 1978 - - 1989-200 1979 1982 1987 - - 1982-1987 1981 1993 1968 1974 1994 - - - - - 1982-1982 1990 - -, 76

4. 1961 12 30 913,. 1968 7 23 ( 2039 ) ( ). 1978, 1979 ( 9495 ). 1981.7) 1980 1982.,,,. 12, (< 4-2> ). 2 ).,.,.,.,..,,,,.. 7) (1995, pp. 189-191). 77

, ( ) (, 1996b, p. 34)8).,.,. 9),..., 1977.,. 1, 2. 10). 50%, 50% ( 80%, 20%).., < 4-3>, 1996 98,, 17.3% (17 ), 8.2% (8 ), 74.5% (73 ).,,. 8), 18, 65.. 9), 14, 3, 2 3,, (, 1992). 10) 1 1,500. (20%), 10. 78

< 4-3> ( : ) 199 1 1993 1995 1996 17 16 16 17 9 8 8 94 92 88 73 117 112 98 : (1991-95) 1996. 4,.,. < 4-4>, 1996 0.83% 3.3%. 1990, 51.2%, 38.9%. < 4-4> ( : %) 1990 199 1 1992 1993 1994 1995 1996 1.7 1.1 0.9 0.98 1.03 0.97 0.83 5.4 5.2 5.0 4.5 4.3 3.9 3.3 : (1996d), 1996, p. 96., 1996 4,582, 4,408 96.2%, 174 3.8%. 1996, < 4-5> : 1996 ( ) (% ) ( ) (% ) 1 61 1.3 57 0.5 2 113 2.5 89 0.9 174 3.8 146 1.4 : (1996a), 96 ; (1996c), 1996. 79

10,596 10,450 98.6%, 146 1.4% (< 4-5> ).. 1991 5%. 1992, < 4-6>.,. 1995 23.8% (17,524 ), ( ) 76.2% (56,004 ).. 11).. 1995 400, 50%.,. < 4-6> ( : ) 199 1 1992 1993 1994 1995 8,274 6,909 7,190 7,954 9,729 4,657 5,120 5,080 5,310 5,716 4,214 2,897 2,172 1,956 2,079 35,000 33,637 36,371 36,829 40,331 2,363 1,736 1,680 2,548 3,276 17,114 9,217 8,438 7.890 12,397 71, 622 59,516 60,931 62,487 73,528 : (1991-1995),. 11) < 4-6> 1995 444 (, 1996d, p. 173). 8 0

4 3.2 1).. 48, 4. 11 (4 1, 5 3, 6 7 6 1 ),. (15 ),,,. < 4-1> - -., 5 5 ( ) 1, 6 2, 7 2. ( 6-7 ),. < 4-1>. 81

2 )..,..,, 1986 6 5, (, 1991, pp. 36-38). 1987.,, 3 ( ), 3,000.,,,, (, 1989, p. 12 ;, 1989, pp. 9-10).., 1996 80 200 1, 200 1, 300 1 (, 1996f).. 82

< 4-7> : 1996 4 10 11-20 21-30 (27) 31 : (1996f).,,,,,,,,,,,,,,,,,,,, (56), (41) 1988 25 1989 1, 1990 56, 1992 202, 1996 336. 318 ( 99, 219 ) 94.6%, 521 215., 56 41, 27. 11 (19 ), (17 ), (17 ) 10, 10 13 (< 4-7> )., 318 7 296 (93.1%), 8 22 (6.9%). 12) 3.3 < 4-2>., (output ) (outcome). (tangible),.,.., (Brudney & England, 1982). 12) (1996f). 83

. (program content ). (specificity ), (feasibility ), (desirability ).,.,,.,,. < 4-2> (delivery system ),,.,.. 84

4...,.,. (task environment ),... < 4-2>. 85

4. 1961, (, 1993, pp. 42-43 ;, 1994, pp. 68-73 ;, 1995, pp. 84-89 ;, 1995, pp. 148-150).,... ( ), (,,. ( :, ),. 4.1 1) ( < 4-1> ).,. < 4-8>, 1 20, 2,500. 21, 2,700.,. 8 6

< 4-8> 4 1 9 9 4 1 9 9 5 1 9 9 6 : (1 / ) ( ) 160,000 1,700 170,000 2,000 190,000 2,500 200,000 2,500 200,000 2,500 210,000 2,700,,,..., 1 107,000 (< 4-9> ). 13,000 173,000 138. 1 300,000. 1 92,000, 8,200 82. 1 300,000 13)., 2,500, 180. 1,050 473. < 4-9> : 1 ( : ) 1986 1988 1990 1992 1994 1996 22,000 29,000 39,000 49,000 65,000 107,000 37,000 44,000 48,000 55,000 65,000 92,000 :. : (1996e) 13) (, 1996e). 8 7

< 4-10> 1 9 9 5 1 9 9 6 ( / ) 14,218 14,368 150 ( / ) 1,020 1,339 310 ( / ) 750 875 125 ( / ) 49,790 85,130 35,340 ( / ) - 72,300 ( ) ( / ) 55,800 84,800 29,000 : (1996b),, p. 15. < 4-9>. 1996 107,000, (18,371 ) (3,851 )..,, 1996 84,800 1 16,000. < 4-10>, 1996. (1 72,300 ), ( 35,100, 1 10,450 ).(, 1996b, pp. 14-15). < 4-11> 1 2 3 4 5 20-16 16-12 12-8 8-4 4 : (1996b),, p. 13. 1,003 2,583 4,583 8,183, 1 88

4.,. 5, 72,513 ( / 1 ) 1,003 (2 ) 8,183 (5 ) (< 4-11> ). 2 ).. ( 3 ).,., 1986 1987. 1, (, ).. 14). 1990 1 48,000 1 132,000 ( ) 36% (, 1994, pp. 33-34).. 1. 14) (, 1989, p. 184). 89

15).,., 1995 ( 150% ).. 1 1 (, 1991, pp. 45-46)..,. 1995 (, 1995d),, (2, ) 16 ),.., 1 1995. 1. 1. 17). 15), 1994 124,000, 1996 99,000, 1998 95,000, 2000 92,000 3.6% (, 1996e). 16) (, 1996b, p. 7). 17)... 90

4.,.,,. < 4-12>, 1996 145, 858 5 1991 (238,245 ) 39%. ( ). < 4-12> : 1992-1996 ( : ) 92 93 94 95 96 202,035 183,085 179,724 174,579 145,858 1 61,277 58,625 55,736 55,582 58,017 2 105,916 107,039 123,988 118,997 87,841 :. < 4-13>, 3.8% 1.4%. 23% 8.4%.. < 4-13> : ( : ) (% ) (% ) (A ) (B ) (B/ A ) 1,506 1,740 3.3 3.8 91 146 0.9 1.4 6.0% 8.4% : 91

3 ). 5... ( ) (,, ). 1994 1 220,359 (, 1994, p. vi) 1 65,000 29.5%...,... (, 1995, p. 194).,.. < 4-14> 1995,,, 64.5% (56,794 / 88,041 ).., 1995, 92

4, 1 1 400g 25. 14,000. < 4-14> 1995 ( ) 65 18 16,362 (100%) 8,677 (53.0% ) 2,346 (14.3%) 2,173 (13.3%) 2,140 (13.1%) 1,026 (6.3%) 88,041 (100%) 9,421 (10.7% ) 29,947 (34.0%) 7,674 (8.7%) 9,752 (11.1%) 31,247 (35.5%) 104,403 (100%) 18,098 (17,3%) 32,293 (30.9%) 9,847 (9.4%) 11,892 (11.4%) 32,273 (30.9%) : 65 18 : (1995c), 95, p. 33, p. 46.. (poverty line)... 5 6.,, 5.,...,. 93

.,. 2 (, 1989, p. 182 ;, 1994, p. vi). 4 ),,,..,,... (Choi, 1991, p. 206).,..... 1.,. < 4-15>, 1995 146,501 (51,710 ) 116,295 (43,587 ) 94

4 79.4%. (26.0%).,. < 4-15> : 1995 ( ) ( ) 146,501 (51,710) 116,295 (43,587) 16,627 (12,627) 16,362 (12,613) 10,877 118,997 (39,083) 11,892 88,041 (30,974) : (1995c), 95, pp. 15-17.,....,. 4.2 1). 95

..., (, 1994, p. 117)..,.,..,.....,., (53.6%) (, 1990)..,, 18 ).. 18). 96

4,..,.,., 11.3% 23.9% (, 1987, p. 81)... 70%.. 19). 1995,... 16.,.,,,.,,.. 19), 6 50.0% 2 4.7% (, 1989, p. 28). 9 7

.,...,. 31%, 44% (, 1992, p. 55). 15. 25 30. 1, 2-3 (, 1995, pp. 241-242)...,,.. 1995 7 2..,,,, 5, ( ) 3., 1998. (, 1996, p. 32). 11 22,. 98

4... 1,... (, )..,. ( ),,,. 2 ). 9 2. 8, < 4-16>.. ( ) ( ).,,..,.. ( :, 99

, ),. < 4-16> : 8 1. (,,, ) 1994., 32.20), < 4-17>,,, 12. 2.,, 18 21)...., 20) (, 1991a, p. 14). 21) ( ). ( ), ( : ) (, 1994b, p. 712). 100

4,,.,., ( 18 ), ( 12 ), ( 37 ). < 4-17> : (1994b), 2, pp. 718-723.,., (, 1993, p. 26). < 4-17> 101

,,.. (1995, p. 87))., 19, 2 8 22)..., ( :, ).., 23)..., 5 2..,,... 36 ( 22) (, 1995, p. 84). 23). 102

4 ).,. (,,,, ) 5/ 10, 5/ 10.. 8/ 10, 2/ 10, 8/ 10, 1/ 10, 1/ 10. 5/ 10... < 4-18>, 1996 < 4-18> 1996 ( : ) 21,793,233 33,617,069 55,410,302 (12,613, 16,362 ) 9,204,956 4,602,478 13,807,434 (19, 8,210 ) 4,084,359 4,084,359 8,168,718 (23,090 ) ( 13,065, 10,025) 6,800,396 6,596,050 13,396,446 ( 2 ) 1,347,360 1,347,360 (47,220, 91 ) 2,444,415 2,444,415 (13,500 ) 2,141,601 2,141,601 (3,660 ) 291,600 291,600 (1,050 ) 472,500 472,500 (320 ) 1,703,522 1,703,522 5,000,000 5,000,000 ( 3 2.5 1, 000 ) 6,255,957 6,255,957 380,749 380,749 : (1996d), 1996, pp. 176-178 24) 103

60.7%, 1994 69.4% (415 288 ). ( 364 ) ( 17 ).. 50% ( 80%). < 4-19>, 1990 119 95 200, 248. 5 108.4%.,, 5-6 ( 2 ).. < 4-19> ( : ) 90 9 1 92 93 94 95 11,097 (46.2%) 11,931 (53.8%) 12,565 (42.8%) 16,806 (57.2%) 12,319 (38.8%) 19,435 (61.2%) 15,330 (43.8%) 19,649 (56.2%) 15,420 (42.8%) 20,631 (57.2%) 19,832 (44.5% ) 24,772 (55.5% ) 24,028 29,37 1 3 1,754 34,97 9 36,05 1 44,604 : 3 ).., 24),. 104

4.., 25)., 39.4% (, 1995, p. 288)26).,. 1994 89 26, 5% (, 1995)..,, LG,,,.,..,,. 40 50,,,. (6 40% ),, (, 1995, p. 520).. 25),.. 26), 105

4.3 1).,..,..,.,.,.,,,,.,.., 4.,,..,.,. 2 ). 106

4...,. 1989. 1991,.,..,., 27)....,. (1994) 211. < 4-20>, 211 15.2% 32 84.8%. 27),, 10 24. 10 7

< 4-20> ( ) (% ) 14 6.6 165 78.2 32 15.2 211 100.0 : (1994),, p. 44. (85.0%), (8.5%), (2.8%) (< 4-21> ) 28). (, 1991), (, 1989).,. (paper compliance) (Choi, 1991, p. 203). < 4-21> ( ) (%) 18 8.5 2 0.9 4 1.9 6 2.8 173 82.0 8 3.8 211 100.0 : (1994),, p. 48. 28). 108

4 (1994). < 4-22>.. 3.3% 91.5%, 5.2%. (89.1%), (95.7% ).. ( ) 74.9%.,,. (88.7% ), 84.3%..,.... 29).,. 29). 109

< 4-22> ( ) ( ) (% ) 11 5.2 193 91.5 7 3.3 211 100.0 65 30.8 123 58.3 23 10.9 211 100.0 101 47.9 101 47.9 9 4.3 211 100.0 17 8.1 141 66.8 53 25.1 211 100.0 3 1.5 19 9.7 173 88.7 195 100.0 53 25.1 125 59.2 33 15.6 211 100.0 : (1994),, pp 49-63. 3 ).,.. 110

4,. (, 1994, p. 161),.. ( ).,.,,, 30).,,, 1.., 80 200 1, 200 1, 300 1. 318 91,000 1 300 (, 1996f) 31), ( : )..,.,,,, (, 1994). 30) (1994), (27.8%), (27.2%), (20.7%), (15.4%). 31) 1 50 70 (, 1993, p. 49). 111

4 ),,,,.,,.., 85% 7...., 3. 7, 8. ( 50%, 96 320 17 ). 4.4 1)., 1994 25 48 700, 1996 40 76 1,000 32). 5 5 6%.. (, 1993)33). 32). 1991 400 1992 500, 1993 1994 700, 1995 900, 1,000. 33), (Ziderman, 1978, p. 51). 112

4, (1 75,000 ), (1 20,000 ), (1 60,000 ) (1 30,000 ) (, 1996d, p. 193). 1996 2,450 18 34).. 35) 30%., 1996 1 430,300 (13,065 ), 1 810,200 (10,025 ) 130 (< 4-23> ) 36 )..,,,,, 1996 1 (8 ) 17,000. 2,441 414 ( < 4-23> ( ) ( ) ( ) ( ) 1 9 9 1 9,318 29 35,000 3,500 1 9 9 2 9,217 25 33,637 2,777 1 9 9 3 8,438 20 36,371 2,798 1 9 9 4 7,890 18 36,829 2,455 1 9 9 5 12,397 23 40,331 2,372 1 9 9 6 13,396 23 41,400 2,441 :, 1996 34) 1987. 1988 120 50, 300. 5. 35),, ( ). 36) 1996. 113

)., (< 4-23> ). 2 ).. < 4-24>, 34,289 (78.7% ), 9,298 (21.3%).., 8,042, 1,256.,. < 4-24> 15,402 1,727 13,675 18,887 10,581 8,306,, 6,858 198 6,660 1,184 25 1,159 1,056 54 1,002 200 28 172 43,587 12,613 30,974 : (1995), 95, pp. 103-107. 23,316 43,587 53.5%., 15.7% (1,979 ) 68.9% (21,337 ) 114

< 4-25> : 1995 37) 4 ( ) ( ) 10,518 1,876 8,642 1,154 181 973 886 306 580 2,893 652 2241 3,609 169 3,440 1,096 532 564 880 36 844 101,417 13,372 12,228 17,409 42,836 14,020 1,552 : (1995c), 95, pp. 118-123..,. < 4-25>, 1995 1,154 11.0%, 9.6% 11.3% 38). 13.2% (13,372/ 101,417 ). 3 )? -, -..., 37).,.. (, 1993) (, 1995, p. 216). 38). (, 1995, p. 214). 115

(, 1995, p. 169). 69.1% ( 93.7%, 64.5%)., (, 1995, p. 169). 130, 400... 1995, 400, 120, 4 5, 3 3.. 91.3%, 54.3%, 25.9% (, 1995, p. 162). (, 1991, p. 271), (56.7%), (28.5%), (9.5%), (5.3%)..,. 312 (946 ) (1995, p. 215), (54.5%) (16.2%)... (, 1995, p. 215). (Goodin 116

4 & Le Grand et al., 1987) (Brew er & deleon, 1983, p. 337)..., (, 1994, p. 272) 39), 20. 30%...,.,. 40).., 8 1 3... 39) (1,000 ) 1/ 2. (2,000 ) (6, ). 40) 1994 106% (, 1995, p. 194). 11 7

41).,. (, 1995, pp. 279-280), 71.6%... ( ) (p. 281)..., (20.5% ), (17.9%), (15.4%), (12.8% ). (40.8%), (21.7%), (13.7%), (11.9%) (, 1995, p. 243, 248)... 30, (, 1993, p. 244).. 57.6% (50,682 / 88,041 ) (, 1995c, pp. 46-48).,.., 41) 19921993. 118

4 42)...,.,. 43).. ( ),, (, 1995, pp. 284-285). 42) (1995, pp. 184-185). 43) (1996b, p.37). 119

5. 5.1 1). 1990 (Osborne & Gaebler, 1992 ;, 1995).,.,..,.,,,. (restructuring )... 2 ). 12 0

4.. 1993 5,., 97 80%,,., (, 1993). 7 5 (1992-1996),., (, 1995, p.47).,.. 1993 1995 14.3% 8.7%. 1993 4.35% 1995 3.96% 44 ). (1995/ 3/ 23),. (16%) (19.5%) 4.09%.. (, 1994;, 1995)., (82.1%), (55.7%), (13.6%) (1.7%). 3 (1996-1998) (98 100% ),, (96 1,000 98 2,000 ), (, 1996b),. 44) (1996, p. 4). 12 1

.,,. 5.2 1)., 1990 12.,,,,, (, 1990, pp. 37-56).,...,.,.,.. 45) (, 1995, p. 81).. 45) (1994). 122

4.,,.. 1998 100%.,,.. 1994 (, 1994)., (4 ) 711,766, 1 220,359. 1 65,000 1/ 3. (1995-96 ) 2. < 4-26> 46), 1.. < 4-26> ( : ) 1 2 3 4 5 6 7 206,402 356,030 545,729 666,684 765,627 843,445 900.680 220,359 380,106 582,632 711,766 817,401 900,480 961,586 : (1994),, p. vi. 205,914 355,188 544,439 665,107 763,817 841,450 898,550 178,455 307,824 471,837 576,414 661,961 729,242 778,727 46) 1-2, 3-4 1-2 (, 1994). 12 3

2 ),.,,.,.,., 5% 0.83% (, 1994, p. 233). 1.4%. Medicaid 10%,. 3 ) :.,., ( ).. 1960-70. 1994. ( ) 50% 400 124

4. (, 1995, p. 307),..,. ( ) 240 640.,.47 ).. (1994, p. 274).,... 4 ), 1995 9.1% (, 1995c, p. 118).. (, 1995, p. 30). 47). 125

..,.. ( : ) ( : )..,,, (, 1995, pp. 293-295).,.,, (needs assessment ) 48 ). (, 1995, p. 222),.,, (, 1995, p. 228). 60..,. 48) 9.,,,. 12 6

4,.,., ( ), ( )..,, (, 1995, p. 162).., (, 1995, p. 227).., (Youth Employment Policy ) (On - Site- Job T raining ) (Elmore, 1979).., ( ).,, (, 1993, p. 244). (, 1995, pp. 296-297).. ( 6%). 49). 49) (1995, p. 297) (AFDC) (matching fund).. 12 7

..,. 5.3 1)...,.,....,.,,,.,,,.,,., (, 1994, p. 212). 128

4.,.,, ( 10%)......,,.........,., 12 9

(, 1995, pp. 129-130). 50). ( ).. 2 )...,,., (screen out ).. (imper sonal)., (, 1990, p. 109). (Hill, 1988, p. 85), (role confusion ). 50) 1991.,,,, 5. 130

4...,.. (Berman, 1978, p. 175).., (paper compliance).,.... 2,....,.. 131

3 ),,.. (T he Job T raining Partnership Act of 1982) (, 1988, p. 175). (public and private partnership).,..,,.., (coproduction ).,,..,... ( ) (, 1996, pp. 360-362). 5 1).. 51) (1996, pp. 364-367). 132

4,,.. ( ).,, 52).,...,.. ( ).,,.,, ( ) 53 ) 54). 52) (, 1996/ 8/ 30). 53). 54) (1995, pp. 525-543). 133

5.4 1).,,.,..,...,,.,.,.,, 55)., 56).. 2 1998. 55) (1995, p. 270), 3-4 1-2. 56)... (1995, pp. 146-158). 134

4. ( :, ),.,.,,,.,,. 20-30....,,, (, 1995, p. 90). 2 ),..,,.,,.,..., 1 100, 200. 135

,...,,.,.... 14. 136

5 5 ( )...,., 25....,,,, 4. 13 7

5 5 1. 1.1. 36 3... 96.2% 60%. 3.8%...,..,.. 10% 34% 25%.., 25 139

....,. 1.2 2 8 25.. 1,..,,,.. 1.3,,. < 5-1>. 14 0

5 < 5-1> - - - - - - - - - - 141

1,,,. 2 1... 3 2... 4 3,,.. 2.,. 3.,. 4 25.. 5, 3 4. 6. 142

2. 5 2.1,. (, 1995, p. 81). (, 1993).,. (national health service),..,..,.., ( )..,..,. 1977 143

< 5-1> ( 1 ) ( 2 ) 1 2, < 5-1>. 1977. 1979, 1988, 1989.,.,,. < 5-2>. 1977 1.. < 5-3>.,,.. < 5-4> 1996 4,582 96.2% 4,408 ( 2,252, 1,675, 481 ), 174 (1 61, 2 113 ) 3.8%. 144

5 < 5-2> ( ) 2 8% - 1/ 2-1/ 2 - - ( 50% ) 3.8% - 1/ 2 1/ 2-50/ 100 30/ 100 20/ 100, ( ),, ( ) 1 2,,,, ( ) 1 2 50% 50% 20% 145

< 5-3> 1 ( ) ( ) 2 1 1,500 : 80% 20% (10 ) < 5-4> (1996 ) ( ) (%) 1,675 36.6 481 10.5 2,252 49.1 4,4 08 96.2 1 61 1.3 2 113 2.5 174 3.8 4,582 100.0 : (1996a), 96. 14 6

5. (, 1990).,.,.,,.,. 1995 88.7%, 86.7% (, 1996a ).. < 5-5> 1995, 57,188, 8,714, 13,681, 43,269, 120,415. 1985 1995 10 1.93, 2.30, 2.52, 1.45, 2.04., < 5-6> ( ) 1 90 887 95 681, 1 90 4,457 95 3,278, 1 90 1,155 95 1,036, 1 90 482 95 372.,., 1, 570 (92 ), 419 (88 ), 446 (91 ), 437 (88 ), 395 (90 ), 391 (84 ), 333 (89 ) 681 (95 ) 120 205%.. 1,. 1,. 14 7

< 5-5> ( : ) 1985(A ) 1990 1991 1992 1993 1994 1995(B) 29,596 42,554 45,496 48,390 51,518 54,406 57,188 3,789 5,792 6,120 6,839 7,569 8,179 8,714 5,436 9,619 10,137 11,285 12,180 12,939 13,681 29,866 37,118 38,396 39,564 40,779 42,037 43,269 59,104 89,032 95,335 101,140 107,883 114,320 120,415 B/ A 1.93 2.30 2.52 1.45 2.04 : (1995a),., 1995, 96, 1996. 4.. < 5-6> ( : ) 1 ) 1990 1991 1992 1993 1994 1995 887 838 791 746 714 681 4,457 4,268 3,869 3,620 3,436 3,278 1,155 1,127 1,104 1,080 1,057 1,036 482 454 432 408 389 372 320 300 287 277 244 246 * ( 92) ( 91) ( 88) ( 88) ( 91) ( 90) 2 ) ( 84) ( 89) ( 91) 570 725 437 419 446 395 391 333 405 1,628 - - 1,685 1,852 1,639 1,754 1,493 1,099 878 - - 1,493 1,205-1,961 1,099 704 156-115 121 103 108 299-101 74( 90) 247( 81) 104( 88) 194( 88) 137( 88) 69( 88) 91( 88) 143( 88) 65( 81) : 1) 2). : (1996a), 96. 148

5. 95 12 29,773 ( 19,624 ), 196,232 (< 5-7> ). 90 320 95 246 (< 5-6> ). 74 (90 ), 194 (88 ), 137 (88 ), 104 (88 ), 69 (88 ), 91 (88 ), 143 (88 ) 1/ 4 1/ 2.. < 5-7> (95 12, :, ) 29,773 196,232 266 440 14,343 96,865 50,188 44,610 100 30 99 29 8,304 110 5,997 3,666 246 577 177 216 * : 19,624 : (1996a), 96... 1992 8 26 1) 139,751 (10.9%), 1,146,559 (89.1%) (, 1995a ). 1992 5,101, 41,849. 10 2,626 2.6%., 1),,,,,,,,,. 149

2.6% (, 1995a ). (,,, ) < 5-8>. 1985 1994 2.32, 1.78. < 5-8> ( :, ) 1985(A ) 16,358 1,335 1 45 12 43,830 1 25 1990 29,387 2,226 81 13 61,774 60 1991 1992 1993 1994(B) 30,824 (4.9) 32,482 (5.4) 34,578 (6.5) 37,993 (9.9) 2,405 2,524 2,733 2,919 84 89 95 104 13 13 13 13 63,891 (3.4) 71,276 (11.6) 75,101 (5.4) 77,815 (3.6) A/ B 2.32 2.17 - - 1.78 120 169 175 195 *. : (1995a),. (, 1995b, pp. 130-131). < 5-9>. 70 GNP 2 3%. 70 30 40% 80 GNP 4.0%. 80 15 0

< 5-9> : 1985 1993 5 (10 ) GN P GD P (%) (% ) (%) 1 1 * $ (%) 1985 3,817.7-4.81 4.65 93.6 108 117.8-1986 4,260.4 11.6 4.59 4.45 103.4 117 125.5 6.5 1987 4,814.6 13.0 4.39 4.29 115.7 141 135.6 8.1 1988 5,941.8 23.4 4.52 4.46 141.4 194 155.5 14.7 1989 7,359.6 23.9 4.97 4.93 173.4 258 185.8 19.5 1990 9,103.3 23.7 5.11 5.07 212.4 300 212.4 14.3 1991 10,656.5 17.1 4.97 4.94 246.3 336 231.0 8.8 1992 12,931.3 21.3 5.42 5.42 296.2 379 266.3 15.3 1993 14,584.2 12.8 5.49 5.49 328.1 409 287.0 7.8 1 1 1990 GNP. : (1996), : 1985-1993. GNP 4.8% 10%., 1985 1987 12.3%,. 1988 20%. 1989 1990 24%, GNP 1990 5.1%. 1991 1993 GNP 5.5%. 1985 3 8,177 1989 7 3,596, 1993 4 14 5,842. 1985 1993 18.4%. 1985 93.6 1 1990 212.4 ( 17,696 ) 2.3, 1993 328.1 1985 3.5., 1, 1993 151

1985 2.4, 1993 8 2.4. (1996), 1.. 1993, (,, ) 100,,, - 14,1%, 35.5%, 6.7%, 71.9% 1., 1985 1993 18.4% 70%, 13%. < 5-10>. 1 1992 $379, 1/ 9 1/ 5, 1/ 4. (OECD) 24 1/ 5.,. 1 1 1.527. 1 1992 579, 1/ 5 OECD 2/ 5. OECD 1,... 152

5 < 5-10> OECD 1 (GDP) (NHE ) ( : $, %) 1 N H E/ GD P 1990 1992 1990 1992 1,314 1,720 1,539 1,519 395 1,300 1,190 1,463 133 977 2,686 1,451 1,949 1,745 1,775 452 1,497 1,376 1,317 156 1,151 3,094 8.2 9.3 8.9 8.3 5.3 8.1 6.6 8.6 4.0 6.2 12.6 8.8 10.3 9.4 8.7 5.4 8.5 6.9 7.9 4.1 7.1 13.6 OECD 1,217 1,374 7.6 8.1 300(458) 379(579) 5.1 5.4 * OECD 1 1., 1989 GDP PPP. : (1996), : 1985-1993. 2.2.,. 1) < 5-11> < 5-12>. 153

< 5-11> ( ) (%) (%) (% ) 1975 1979 1984 1990 1991 1992 1993 1994 1995 60(34.5) 58(18.8) 66(14.8) 58(10.1) 63(10.6) 67(11.1) 61( 8.7) 60( 8.1) 89(11.3) 115(65.7) 250(81.2) 380(85.2) 514(89.9) 532(89.4) 536(88.9) 643(91.3) 684(91.9) 700(88.7) 175(100.0) 308(100.0) 446(100.0) 572(100.0) 595(100.0) 603(100.0) 704(100.0) 744(100.0) 787(100.0) : (1996a), 96. < 5-12> ( ) (%) (%) (%) 1985 1990 1991 1992 1993 1994 1995 14,757(19.8) 16,826(18.1) 19,100(19.0) 20,214(18.9) 21,442(17.0) 20,958(14.8) 20,040(13.3) 59,608(80.2) 75,900(81.9) 81,519(81.0) 86,906(81.1) 104,684(83.0) 120,309(85.2) 130,592(86.7) 74,365(100.0) 92,726(100.0) 100,619(100.0) 107,120(100.0) 126,126(100.0) 141,267(100.0) 150,632(100.0) : (1996a), 96. < 5-11> 1975 34.5%, 1984 14.8%, 1990 10%. 154

5 < 5-12>, 1985 19.8% 1995 13.3%., < 5-7> 95 196,232 < 5-12> ( ) 20,040 10%., 10% (95 ) 92% (83 ) 95% (83 ), 34% (87 ), 25% (86 ) (< 5-13> ). < 5-13> ( : % ) (95 ) (87 ) (86 ) (83 ) (83 ) (83 ) 10 34 25 35 92 95 90 66 75 65 8 5 : (1994a),. < 5-7> < 5-12>., 1994 15.2%, 14.7% (< 5-14> ). < 5-12> ( ) 14.8% (94 )..,,.,,., ( ),,, (, 1996, p. 30). 155

< 5-14> (1994 ) ( ) (% ) ( ) (%) 2,712 3,050 7.2 8.0 2,247 9,188 2.9 11.8 5,762 15.2 11,435 14.7 26,327 5,904 69.3 15.5 46,813 19,567 60.2 25.1 32,231 84.8 66,380 85.3 37,993 100.0 77,815 100.0 : (1995a),. < 5-15>.,.,,. 90% (, 1979). 1980 68%, 1988 (< 5-14> ). 1990 62.8% 1993 66.7%. 10%. ( ) 1990 33% 1993 28.3%.,,,. (, 1994a, pp. 89-111).., 30 15 6

5 < 5-15> ( : % ) * 1985 1986 1987 1988 1989 1990 1991 1992 1993 100 100 100 100 100 100 100 100 100 8.6 10.1 9.3 10.2 10.5 11.4 11.8 10.4 10.0 6.5 7.9 7.2 8.4 8.8 9.9 10.3 9.0 8.6 2.1 2.2 2.1 1.8 1.7 1.5 1.5 1.4 1.4 23.3 21.6 22.2 23.4 23.9 25.9 22.9 23.3 23.3 16.6 14.7 15.2 16.4 16.9 19.7 16.4 16.8 16.8 2.2 2.3 2.2 2.1 1.8 1.9 1.8 2.0 1.5 4.5 4.6 4.8 4.9 5.2 4.3 4.7 4.5 5.0 68.1 68.3 68.5 66.4 65.6 62.8 65.2 66.4 66.7 55.0 56.7 57.7 55.2 56.7 53.9 57.1 56.3 56.8 13.1 11.6 10.8 11.1 9.0 8.9 8.2 10.0 9.9 * : (1996), : 1985-1993.. 1960 75.5%, 90 57.6%. 60 24.5% 88 40.6%, 90 42.4%, 91 43.9%. 60 Medicare Medicaid.. 3/ 4, 1/ 4,., 1990 24.6%, 6.8% 1/ 3, 56.3%, 88%. 10%.., 10%, 10% ( 30% ). 15 7

2 ),,,,. 3, 4, 3,, (< 5-16> ). < 5-17> 8. < 5-18> 10, 9, 4,. 44, 15 (< 5-19> > ). 1950. 1960 1982 2). ( ).. 1956 ( ) 1,,. 1995 12 238, 1,327, 2,039 (< 5-20> ).,, 1996 7. 2) (1983). 158

5 < 5-16> 10 ( ) 643 600 450 900 400 300 768 360 2,600 200 1 500 11 7,72 1 < 5-17> 8 1,546 750 831 769 668 783 520 592 8 6,459,,,,,,,, 159

< 5-18> 10 ( ) ( ) ( ) ( ) 9 4 2 480 203 87 122 60 214 200 70 45 20 298 200 206 380 300 400 270 200 300 652 380 300 300,,,,,,,,,,,,,,,,,,,,,,, 1 500, 24 6,187 160

5 < 5-19> 8 200 405 460 340 200 250 400 200,, ( ),,,,, ( ), ( ) 2 400 331,, 1 300, 1 300, 1 200, 7(1) * 132 161 180 75 242 150 31,,,,,,, 8(2) * * 250 125 102 120 130 300 30 30,,,,,,,, 2 120 186,, 161

< 5-19> 5(1) * 160 172 205 357 30,,,,, 4(2) * * 340 250 26 28,,,, 7(4) * * * * 185 80 120 30 30 40 40,,,,,,, 6(3) * * * 200 120 288 20 23 30,,,,,, 5(2) * * 250 80 200 30 30,,,,, 2 200 160,, 59 (15 ) 10,074 (448 ) * ;. 162

5 < 5-20> ( ) ( 95 12 ) 238 1,327 2,039, ( ) 966 ( ) 2,070 2,039 : (1996a), 96.,.,., ( ),.,, (< 5-2> ).,. 163

< 5-2> ( ) 164

5 2.3 1) 1996 < 5-21>. ( ) 10,596, 10,450 ( 5,218, 4,169, 1,063 ) 98.6%, 146 (1 57, 2 89 ) 1.4%.,. 3 ) < 5-21> ( ) (%) 4,169 39.4 1,063 10.0 5,218 49.2 10,450 98.6 1 57 0.5 2 89 0.9 146 1.4 10,596 100.0 : (1996c), 1996. 1,740 3.8%, 146 1.4%., 23% 8.3% (< 5-22> ).., 3) 50%, 80% ( 21 20 ). 165

,. 50% (< 5-23> ). < 5-22> (1996 ) ( ) ( ) 4,582 1,060 1,740 146 23% 8.4% 3.8% 1.4% 11,097 (46.2%) 11,931 (53.8%) < 5-23> ( : ) 90 9 1 92 93 94 95 12,565 (42.8%) 16,806 (57.2%) 12,319 (38.8%) 19,435 (61.2%) 15,330 (43.8%) 19,649 (56.2%) 15,420 (42.8%) 20,631 (57.2%) 19,832 (44.5% ) 24,772 (55.5% ) 24,028 29,371 31,754 34,979 36,051 44,604 : 94 12 9,246, 48,589 (< 5-24> ). 28,134 32.9% ( 71 253 28.1%), 182,159 26.7% (, 1995). < 5-6> 246 (94 ) 222 (< 5-25> ). 23.7% (94 ). < 5-25> (94 ), 15,507, 2,268, 3,438, 8,460, 15,464 166

< 5-24> 5 (94 12, :, ) 9,246 48,589 71 102 4,162 31,661 9,316 6,601 2,743 44 2,057 904 87 38 24 25 * : (1995),. < 5-25> (94 12 ) * 15,507 2,268 3,438 8,460 15,464 48,598 ( ) * * 696 4761 3,141 1,276 698 222 *. ** ( ) = 94 10,798,700 / ( ) : (1995),.., ( ) 1 608, 1 3,141 < 5-6> 1 714 1 3,436.4) ( ) 38.7% 4), < 5-25>, < 5-6>,. 16 7

(, 1995).. ( ) 1 570 (94 ) 275 (94 ), 222 (93 ), 110 (91 ), 306 (94 ), 539 (92 ) (< 5-26> ).. 1 ( ) < 5-26> * 1 (1994 ) *. (1994 ) (1994 ) (1993 ) (1992 ) (199 1) 570 275 306 222 539 110 : (1995),. 2 ).,. ( ), ( ), ( ), ( ) 4, ( ), ( ), ( ) ( ) 8. 3 (,, ), 3 (,, ), 1 ( ) 1 5. 8 2,455 95 49,470 5%. 5) 1 ( ) 25 1 5) 3. 168

5 25. 8 25. 8, 2 ( ) 6. < 5-3>..,..,.. 25,.,..6) 6), (, 1995, pp. 159-176). 169

< 5-3> 25 1 70

3. 5 3.1 1) (, 1994, pp. 25-26). 1899 (Allen ),. 1905,,., 1908 ( ). 1918 ( ) 1929 ( ). 1947, 1948, 1955 8. < 5-27>,,,,, 6. 1987, 1996. < 5-28>,,, 4,, ( ), ( ), ( ) 3 8. 96 2,455. 6, 460, 405, 340, 250, 200.,.,, 1 71

< 5-27> 1908 ( ) 1918 1977 1982 1929 1934 1957 ( ) ( ) 1948 1968 1969 1978 ( ) 1955 1960 1963 1964 1973 1947 1961 1969 1955 1987 1991 ( ) 1987 ( ) 1996 ( ) 1 72

5 < 5-28> ( ) ( ) * ( ) 95 (% ) 51,979 2,455 26,514 (2,930) 1,626 2,504 13,510 2,029 16 200 246 44.3 4 250 229 1.3 2,628 3 200 134 29.0 1,155 20,805 4,036 8 340(815) 199 20.0 1 4,059 7,018 1,000 1,744 1,500 1,413 19 405 616 92.8 400 - - 200 - - 6,851 25 460 613 86.1 6,615 *. :. 5. ( ),, 1.. < 5-29>., 200, 240. 2. 1 73

< 5-29> : (1996a), : : 200 : : 240 3. 96 10 2 ),,,, 4. 7) 1987 9, 1987 9 3 (97 12 31 ). 1982 9, 49. 1987 1996.,. < 5-30>. 7) 1.,.. 1 74

< 5-30> 5 ( ) 3 ),,.,,, < 5-4>.,,,.. 8)..,,,., 3, (, ).. 1987 9 8) 2 2. 1 75

< 5-4> < 5-5>.. 7,, 3 3.9 ),,,,.,,.,..,, ( ). < 5-4>. 1982 < 5-6>. 9) 4 3 ( 3 14 ). 1 76

5 < 5-5> (1996 ) (19 ) (2 11 ) 1 77

< 5-6> (1996 ) (1 ) (2 ) (2 ) ( 102 ) (2 ) (1 3 ) (1 ) 25 (2 ). ( ),,,, 5.,,,,.,..,.,,, 25,,,,.,,.. 1996 < 5-31>.., 1 78

< 5-31> (1996 ) 5 (% ) ( + ) (%) (%) 246 214 87.0 61 41 67.2 84 83 98.8 229 225 98.3 12 12 100.0 89 93 104.5 134 124 92.5 14 8 57.1 34 34 100.0 199 191 96.0 19 16 84.2 66 67 101.5 616 595 96.6 132 125 94.7 196 195 99.5 613 580 94.6 154 131 85.1 204 204 100.0 2,037 1,929 94.7 392 333 84.9 673 676 100.4 : 4 72.6%. 100%.,. 4 ),,,. < 5-32> 1996.,, 3 25, 19, 16. 1995 < 5-33>. 95 ( ) 603,141, 786,013 1,389,154 ( 865,144 ).,,,,.,, 1 79

< 5-32>,,,,,,,,,,,,,,, 16,,, 4,, 3 1, 2,,,,,, 8,,,,,,,,,,,,,,,,,, 19 1 1,,,,,,,,,,,,,,,,,,,,,,,, 25 : 18 0

5 < 5-33> (1995 ) ( :, % ) ( * ) 12,378 (38.3) 19,942 (61.7) 32,320 (100) 56,217 (78.6) 15,269 (21.4) 71,486 (100) 31,117 (55.4) 25,032 (44.6) 56,149 (100) 735 (0.5) 133,937 (99.5) 134,672 (100) 3,739 (95.0) 197 (5.0) 3,936 (100) 1,981 (1.5) 134,003 (98.5) 135,984 (100) 29,157 (46.9) 32,966 (53.1) 62,123 (100) 7,600 (93.2) 553 (6.8) 8,153 (100) 31,690 (48.9) 33,150 (51.1) 64,840 (100) 42,591 (44.3) 53,500 (55.7) 96,091 (100) 97,177 (90.2) 10,581 (9.8) 107,758 (100) 74,983 (56.8) 57,027 (43.2) 132,010 (100) 84,861 (26.1) 240,345 (73.9) 325,206 (100) 164,733 (86.1) 26,600 (13.9) 191,333 (100) 139,771 (35.9) 249,212 (64.1) 388,983 (100) 103,557 (77.6) 29,849 (22.4) 133,406 (100) 295,804 (91.9) 26,137 (8.1) 321,941 (100) 202,158 (84.0) 38,561 (16.0) 240,719 (100) 100,518 (69.5) 44,011 (30.5) 144,529 (100) 226,854 (83.2) 45,885 (16.8) 272,739 (100) 176,136 (74.8) 59,306 (25.2) 235,442 (100) 288,936 (47.9) 314,205 (52.1) 603,141 (100) * = + / 3 ** (%). : 687,391 (87.5) 98,622 (12.5) 786,013 (100) 518,065 (59.9) 347,079 (40.1) 865,144 (100),,,., 24, 13,,., 52.1%, 12.5%, 40.1%.. 50%.,,,,,, 181

,. 40.1%,, 4 64.1%. 25.2% 16.0%.... 2.... 5. 6. - - - - - - - 30%. 1, 6, 1, 1 ( 4 ). 4,. 182

5 ( 22 2 4 )., ( 6 ). 5 ) 4. 1979 1993. 1994.., ( 2 3 ). ( 13 )..,,. 5., (300 ),. ( 7 1 ). 3.2 1994 94. 10) 183

1) 6 < 5-34>. < 5-34> 100 ( ) ( ) 182.1 256.8 164.8 199.3 145.0 182.7 217.3 14.4 26.0 30.4 3.0 21.0 89.5 84.1 90.6 86.4 67.1 80.2 78.4 87.1 78.7 88.1 20.5 75.0 ( ) 135.0 135.2 136.5 131.4 108.6 131.5 119.7 104.0 104.5 103.7 22.8 83.2 ( ) 13.0 10.9 22.3 11.8 14.3 13.4 11.7 44.8 72.5 81.3 47.7 89.8 (%) 35.9 15.7 22.8 21.4 18.6 25.2 24.3 7.3 17.5 11.7 5.8 114.0 251.9 239.8 45.6 : (1995a), 94.. n.a. 100,, - 100 182.1, 89.5, 135, 100 256.8, 84.1, 135.2,. 10) (1995a).,,, 3,,.. 184

5-100 145, 67.1, 108.6. - 100 14.4, 87.1, 104.0. - 100,,.,.. - 100 5.8, 114.0 6, 251.9... 100 (% ) (% ), ( ), (%). 11) 100 (%),,,,,., 11). ( ),.,,.. ( ) 1,. (, 1995b. pp. 35-36). 185

.... 239.8,.,. 35.9%.,,.,,,,. 2 ) < 5-35>.. 6. - 116.6%,. 100 1,. 1.,.,,,., 18 6

116.6 105.8 105.6 98.8 163.2 112.2 100.1 331.6 112.5 91.1 399.2 92.4 < 5-35> 5 ( : %, ) 100 1 1 348.2 440.5 311.2 390.4 183.9 228.5 281.0 39.2 56.4 92.5 13.8 103.0 88.4 108.8 77.0 99.6 60.7 61.4 75.9 12.4 24.6 27.3 19.8 52.9 103.1 115.1 81.3 98.4 99.1 68.9 76.0 41.0 27.7 24.8 79.2 48.9 43.1 44.0 34.4 41.4 35.2 43.0 24.5 39.1 24.8 28.1 22.4 17.9 n.a. n.a. n.a.. n.a. n.a. n.a. n.a n.a. n.a. 9,215.5 1.5 0.2 17.9 n.a. n.a. n.a. : (1995a), 94... - 105.8%,.,.. - 163.2%.,. 18 7

-,,..., 5,,,, 4.. 6,.. 3 ) 12), 13), 1, 1 < 5-36>. 6., 4.. 12) (= / ) (%).. 13) (= / ).. 188

5 < 5-36> (% ) 62.7 59.8 63.0 73.8 n.a. 36.7 46.9 n.a. 36.0 42.2 n.a. 49.2 1 1 (%) ( ) ( ) ( ) ( ) 113.3 130.3 143.5 136.5 65.5 127.0 141.1 32.1 120.3 171.8 13.4 174.1 132.9 161.1 371.9 193.9 102.2 376.8 297.1 632.8 661.9 1,169.7 339.5 1,064.1 11,748.0 17,518.0 25,132.0 17,884.0 6,207.0 22,038.0 23,765.0 7,832.0 23,646.0 33,909.0 6,737.0 46,092.0 30.3 30.8 44.0 33.0 22.0 48.0 36.3 51.4 69.2 81.7 26.9 59.9 2,677.0 3,350.0 3,158.0 3,198.0 1,337.0 2,824.0 2,923.0 637.0 1,547.0 2,331.0 535.0 2,117.0 n.a. n.a. 1,947.5 378.0 104.8 20.0 : (1995a), 94.. 4 ) < 5-37>. - 100 135.6, 133.5, 100,.. - 100 150. 100,,. -, 100. 189

,. 4 100,. < 5-37> 100 ( : ) 135.6 30.9 56.0 26.8 19.3 133.5 25.5 63.0 25.1 11.2 101.8 16.9 43.4 17.2 24.3 124.1 25.1 51.9 21.5 25.6 150.0 86.7 106.8 61.5 39.2 43.9 56.2 40.8 32.3 12.0 15.0 5.0 3.9 3.6 57.3 36.8 47.3 19.0 17.2 18.7 20.2 14.1 20.1 4.0 5.4 8.5 40.2 23.9 24.4 33.5 12.8 13.2 n.a. n.a. n.a. n.a. 73.1 n.a. n.a. n.a. n.a. : (1995a), 94.. 5 ) 6,,, 4. -,,,. - 190,,,,

5 4. 6. -, 4.. -, 4 100. < 5-38>. < 5-38> ) :, :, :,,,, 4.,,, 4. 4. 191

3.3 1) 3, 2 3, 1, 1 8, 2,455. 5%, 10%. 60%,.. < 5-39>. 17, ( ) 9, 2, 2, 4., 4,126, 1,607, 210, 217, 90 6,252. < 5-40>. 47%, 39%.,,. 2 ),, 3 (1993), 23.7%, 32.1%, 18.3%., (, 1996). 192

5 < 5-39> ( ) 470( 438, 32) 248( 248) 789( 741, 48) 462( 375, 87) 382( 342, 40) 595( 525, 28, 42) 556( 384, 172) 116( 116) 296( 264, 32) 259( 221, 38) 130( 90, 40) 1,273( 1,273) 17 242( 202, 40) 160( 110, 50) 150( ) 88( 88) 36( 36) 6,252( 4,126, 1,607, 210, 217, 90) : (1994),,. < 5-40> 8 17 2,455 6,252 ( ) 1,065 800 340 250 4,126 1,607 427 90 * (400 ) (200 ). 193

3 3..,... < 5-31> 84.9%, 57.1%, 67.2%....,, 4 13.47% (< 5-41> ). < 5-41> ( ) 92 93 94 95 T/ O 47 47 47 52 6 8 5 7 (%) 12.77 17.02 10.64 13.46 13.47 :,.. 4,..,. 194

5 3 )., 6, 4.,.,,.,, 4..,,,.,,.,.,.,. < 5-40>.,. 195

90%,,,, 4. < 5-43>,. 95 252 42.3%, 96 18.2% 298. < 5-42> ( : %) 94 95 60.6 44.3 1.4 1.3 31.4 29.0 26.3 20.0 94.2 92.8 92.3 86.1 : < 5-43> 16,013 ( : ) 93 94 95 96 17,737 (10.8% ) 25,239 (42.3%) 29,830 (18.2%) 3,466 3,318 5,311 5,792 4,466 4,922 4,124 7,057 2,027 2,665 3,134 4,067 3,475 4,265 5,701 5,706 932 1,146 3,382 1,492 1,647 1,421 3,587 5,716 *. ** 96. : 196

5 4 ). 5 1.,..,... 14). 3,,.,, 3,. ( ).. 3 98 1,., 15). 14), 1992 6,,,,,, ( ).., (, 1994). 15) (, ),,. 2. 19 7

5 ).,,.... (netw ork).,,,,. 1 2.16) (,,, ).,.. 17)., 2, 2. 16) 2, 1 4.4% (, 1993). 198

4. 5 4.1 1) (25 ) 1.. < 5-7>..,.,,,,,,, 8,. < 5-44>. < 5-7> ( 4 ) 5 ( ) ( ) ( ) ( ) ( ) 17), 24,. 199

< 5-44>,,,,,, ( ),,, (,,,,,,, 8 ),, ( ) 2 ) 96 < 5-45>. 2,110 2,020 96% 88%. 95 622, 25. 34, 9 5. < 5-45> ( : ) 25 135 25 124 97 153 25 664 226 209 427 2,110 25 132 24 109 95 145 25 647 227 185 406 2,020-3 1 15 2 8-17 - 24 21 90 : 2 00

5 3 ) 1.. < 5-46> 95., 273, 10 9. 95 10,596, 1 1 0.26. 1 ( ) 2,509,346 92%, 140,672 5%, 81,872 3%. < 5-46> (1995 ) ( : ) 1 ( ) 2,731,890 109,275 2,509,346 100,373 81,872 3,275 140,672 5,627 * 25. :,, ( )...,, 2,,,,, 100 7 2 01

,. 1991,,,, 5. 1995 25,, 3 8. 17. 12 13 1, 6 9 1. (, 1995). < 5-47>. < 5-47> ( : ) ( ) 1991 1992 1993 1994 1995 163,838 299,822 292,854 299,019 361,932 17,580 68,135 76,943 80,577 86,916 116,279 178,413 163,640 162,346 215,719 29,218 46,529 49,916 53,621 55,239 761 6,745 2,355 2,475 4,058 * ( 94. 3-96. 3) : 7,863 ( 855, 78, 1,955, 467, 1,630, 1,105, 1,773) : (1996b), 1 :. 4.2 (1)., 2 02

5,.,, ( ).. (2),. 25., 18)... (3),,. 1..,,,. 18) 23%. 2 03

(4),. < 5-48> 1995 25 (669,042 ) (145,646 ) 4.6. (47.19 km 2 ) (9.97 km 2 ) 4.7. 1,.,, 1 ( ) 1,942, 8,469, 7,310 4. 1 17,400, 11% 1,900 (< 5-48> ). (5),., ( ),,,,...,. (6).,. (,,,, ). 2 04

5 < 5-48> (1995 ) (k m 2 ) ( ) 1 ( ) 1 ( ) * ( ) 30 (4) 145,646 204,733 260,993 284,609 9.97 23.91 21.87 13.08 75 (70) 80(79) 85 (77) 91(79) 1,942 2,559 3,071 3,128 2,530 2,438 2,382 2,182 17.4 11.9 9.1 7.7 104,556 47,544 55,860 51,246 30-40 (6) 342,648 371,449 374,271 383,224 391,148 395,078 16.84 17.60 20.86 20.15 17.05 23.61 91(87) 86 (81) 93 (88) 91(86) 82(86) 93 (87) 3,765 4,319 4,024 4,211 4,770 4,248 3,069 2,246 3,401 2,675 2,262 2,595 9.0 6.0 9.1 7.0 5.8 6.6 96,035 101,358 75,089 153,074 83,708 73,228 40-50 (8) 400,409 407,887 417,914 420,069 436,684 454,951 487,130 497,614 23.87 47.19 24.56 14.20 16.35 18.52 17.40 24.55 75 (72) 78 (74) 80(80) 83 (78) 78 (75) 92(85) 79 (77) 88 (83) 5,339 5,229 5,223 5,061 5,599 4,945 6,166 5,655 2,223 2,177 2,361 2,502 2,216 2,801 2,565 950 5.6 5.3 5.6 6.0 5.1 6.2 5.3 1.9 133,821 56,929 116,010 110,034 94,356 156,251 157,522 163,082 50-60 (6) 503,272 506,610 523,606 558,462 559,032 599,462 29.71 24.58 41.41 29.57 39.55 35.49 74 (74) 88 (88) 86 (82) 98 (92) 83 (81) 82(82) 6,801 5,757 6,088 5,699 6,735 7,310 2,361 2,604 2,683 3,073 2,958 2,537 4.7 5.1 5.1 5.5 5.3 4.2 121,137 155,842 150,347 141,666 99,941 174,916 60-80 (1) 669,042 33.89 79 (77) 8,469 2,404 3.6 58,338 25 10,595,943 605.78 2,110(2,020) 5,022 62,195 5.9 2,731,890 * 1 ( ), : 2 05

5. 1995,. 5.1 1) 1995 < 5-49>, (, 1996a). < 5-49>..,,,.,,,. 2 06

5,,,..,,,..,,..,.,.., AIDS.,.. < 5-50>.., 1 ( ; < 5-27> ), 200 250. 2 0 7

< 5-50> ( ) ( ) 97.1-98.12 (11,370 ) 96.1-99.12 (44,640 ) AIDS 97.1-99.12 96.1-98.12 (32,898 ) 95.12-96.8 (8,523 ) 96.3-96.12 (14 ) : (1996b), 1 :. < 5-51> ( ) ( ) 200 9917m 2 (3,000 ) 200 9,917m 2 (3,000 ) 200 13,884m 2 ( ) ( ) 9,917m 2 (3,000 ) 40,641 97.1-98.12 32,898 97.1-98.12 46,019 ( 11,000 35,019) 97.1-98.12 *. : (1996b), 1 :. 2 08

5 3 600 (< 5-51> ).. 2 ),,.,.,,.,,, (restructuring ).,.. 8 1 ( ), 1 ( ), 4 (,,, ), 2 ( ).. - 3 98? - ( ),? 4 2 09

3?? - 2, 2,? -,? - 3?,., (,,, ).,,... 5.2 1),.. 2 10

5,..,. (, 1996a, 1996b ;, 1996)...,,,,,,,., 1/ 2,,., 97 2 98 2..,.,,,, 40 64,.,.,,,,,.,.,. 2 11

.,. ( 27% ), 3, 4, 5 1, 2 ( ).. ( ) 98 20, 1 6..,. ( ), ( ). 65,,,,.. 95 12 96 7. ( : 95. 7. 1 97. 6. 30)., (,,,, ) (part - time),. 2 12

5 2 ),,,.,.,,,..,,.,,.,,..19 ),,,,, ( ).20),. 19), (, 1995, pp. 86-97). 20),,,. 2 13

.,, 21) 22). 21) 12 3. 14 17,, 3,, 1. 22) 24 2 22,. 1. 2. 3. 4., 5.. 2 14

5 6. 6.1 1)., 1989. 96.2% 60%, 3.8%., 1.4%, (< 5-52> )., 91 238,245 96 145,858 40%. ( ). < 5-52> ( : ) 9 1 92 93 94 95 96 238,245 202,035 183,085 179,724 174,579 145,858 1 61,277 61,277 58,625 55,736 55,582 58,017 2 137,113 105,916 107,039 123,988 118,997 87,841 39,855 34,842 17,421 94 : 2 15

Medicaid 10% 23 ). 5% (, 1990)., 10%. 3.8%, 1.4%., 24),..,,,..,,.,,,, AIDS,.,., 23) 1965 Medicaid 1966 Medicare. Medicaid. Medicaid, ( 50% ).. Medicaid 89 2,290. Medicare 65. Medicare,. Medicare 89 3,300 (, 1994a, pp. 88-96). 24) 2, 5 6.,.. 2 16

5. 119.,,..,....,,,... 2 ). 2,455 5%, 39%...,, 3 2,455 1/ 4. 2 1 7

( ),. 25),, 3., 815 340, 20,805. 100 200 300. 26), NIMBY. ( ) 3. (< 5-8> ). < 5-8> 25), (, 1993). 26),, ( < 5-39> ).. 2 18

5 3 1 2.27) 3..,,.,..,,., 200 300 28). 50... 4.,., 27) 3 3., ( ), 3 3. 28) (< 5-39> ). 2 19

.,.,,,...,.,,,....29) (,, )..,,. 4..,, (restructuring )..,.. 29),? 31%. (, 1993). 22 0

5 98 1,.. (1993) (1993) (1983)., < 5-33> 30.5%, 16.8%. (, ). 30)..,..,,. 31) 10.,. 3,,. 32) 3 30),,,,,... 31) ( 52 2 ). 22 1

,, 33 ). 4., (network).,.,,.,.,, AIDS,,,.34 ).,,, 25 < 5-53>,,,. < 5-54>.. 32),. 33),. 34), ( ),. 222

< 5-53> ( ) 5,,,,, 6,,,,,, 7,,,,, 6,,,,, 6 < 5-54> ( ),,,, 5,,,, 5,,, 4,,, 4,,, 4,, 3.., 4 119. 35),,. 3 ). 35) (,,,, ) (, 1996b). 22 3

.,.,,,,,, 6. 3.. 98.,.,,,,,,, 7.. 99.,,.,,,,, 6. 224

5. 340 100. 200 300,. AIDS...,,,,,, 6..,, 200 250 300.. (Community Mental Health Center ). 50..,. 225

. 250 300,. 12,. 4 ),, 4 < 5-55>. < 5-55>. ( ),. 4,,,. 4. 4., NIMBY.. 22 6

< 5-55> 5 AIDS ( ) ( 400 ) 22 7

< 5-9> 3 2 25 4, ( ),. < 5-55>,. 3 1, 2 (< 5-9> ).,. 3,. 3. 3 228

5, 3 2. 6.2,. 1),,.,... 2 ),,.36) (outsourcing ) 37). 36),. 37) ( 22 ). 22 9

3 ) 38)... 4 ),.,, 25. 5 )... 6 ) < 5-53> < 5-54>,,,,,. 38),,. 2 30

5,.. 39 ) 6.3,.,.,...,.,,,. 40 ) 39).. 1. 2. 3. 4. 40), (,,, ), (,,, ),, 2 31

..,.. 41),.,,.,. 6.4,. ( 9 ).. (, 1995b, p. 159). (,, ) ( (1994) ). 41) ( ). 1. 2. 3. 4. 5. 6. 7. 8. 2 32

5.42),,.,,,.,,,,,,, AIDS,.. ( ),,. (,, ) MRI( ),. 42) 92 96 IBRD 3,000 (, 1995b, p. 159). 2 33

6 6 ( ) ( ) ( ) ( ) 2 35

6 6,,,., 30...,,,..,...,.,,,,.,.,,......,. 2 3 7

.,.,...,.. 1......,...,..... 2 38

6.. 4.,.,,.. 1.1......,... 1).., 2 39

.,,.. 2...,.,., 5% 0.83%....,.... 2 ) 1995 9.1%, 24 0

6..,,.,,..,,,,..,..,. 1.2..,.... 1) (, 241

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