论欧盟国家卫生制度设计的团结安排及变化趋势

Solidarity as a system design element for the European health care system and its trend

团结思想是欧洲卫生公平和卫生政策的重要基础,但正不断受到个人责任、自由主义、私营化改革等新理念冲击,在部分欧洲国家甚至存在因资源匮乏而加大个人自付弱化团结的危险。但团结仍然是欧洲卫生体制安排最具标志的价值观之一,并继续成为欧洲政府对卫生安排的政治承诺和问责的道德基础。在从大政府走向大社会这一全球医改浪潮中,欧洲多国政府通过加强精细化监管来进一步实现卫生系统团结。

Solidarity is the foundation of European health care and policy. However,it is constantly discussed by the new concept of personal responsibility,liberalism and privatization. In some European countries,out of pocket money was used more because of the limited resources which indeed weakened the solidarity,an element which consistently marks the difference among the European Union countries,and the main source of European political commitment and accountability associated with health. In the universal health care reform tide,the European government restrains its power in detailed operation on the health care and pharmaceuticals delivery,medical insurance design,and health resource allocation,but this is done through more specific supervision to ensure solidarity in health care system.