期刊文献+
任意字段
题名或关键词
题名
关键词
文摘
作者
第一作者
机构
刊名
分类号
参考文献
作者简介
基金资助
栏目信息

中国卫生保健政策:对北美和西欧失误的反思 被引量：1

Chinese Health Care Policy:Reflections on the Failures of North America and Western Europe
下载PDF
导出
摘要 通过分析美国及其西方一些国家在建立医疗可持续发展的卫生保健金融体系过程中所遇到的问题,比较发展中国家———特别是中国与发达国家在建立可持续发展的保健金融系统时所面临问题的异同点。为解决中国,特别是农村医疗保健问题提出了建议。认为中国将成为世界经济大国,应该严格审查其生物伦理学基础(包括医疗保健制度)是否满足经济发展和人民健康利益的的需要,利用有限的卫生资源保证国民享有相对同等水平的医疗保健服务;树立在道德指导下的生物伦理学观念,取消医疗消费和财政拨款上的平均主义,节省和减少医疗费用的超高预算和过度支出;建立多元化的医疗保障体系,如私立营利性、私立非营利性、地方政府和中央政府的医院、保健机构等既相互竞争又相互协作的保健系统,保证卫生政策和道德标准的协调统一,授权的机构以契约、市场和法律的方式进行管理;处理好政府、私人和市场的关系,多方筹措资金,建立成功的、有创造性的保健制度和生物医药产业。同时指出,在经济不发达的国家和地区,应该建立这样的医疗保健系统:①保障基本的国民医疗保健服务,要求不要太高;②承认医疗保健地域之间存在的不均衡性;③患者及其家属应该对医疗保健费用有所了解。作者通过对各种不同的医疗保健服务提供者及其医疗保健不同付款方式的分析,指出权利的过度赋予和平均主义式的财政支持均不利于医疗保健事业的健康发展。 Through analyzing the problems health care financing system, and comparing the proposal for health care financing system is given egalitarian ideology should be avoided. American and Western European met in establishing sustainable difference of the problems in developed countries and developing, in the paper. The author points out that entitlement mentality and
作者 恩格尔哈特 张殿增 刘聪
机构地区 医学与哲学杂志社 西安交通大学医学院
出处 《中国医学伦理学》 2006年第1期10-15,共6页 Chinese Medical Ethics
关键词 卫生保健政策 财政支持 生物伦理 道德标准 医疗保健服务 health care financial support bioethics particular moral
分类号 R-01 [医药卫生]
  • 相关文献

参考文献11

  • 1For an overview of the increase in health care expenditures from 1960 to 1997,see G.R.Anderson and J.Pierre Poullier," Health Spending,Access,and Outcomes:Trends in Industrialized Countries," Health Affairs 18 (May/June 1999),178-192.For an analysis of the distribution of health care expenditures among the American population,see Marc L.Berc and Alan C.Monheit," The Concentration of Health Care Expenditures,Revisited,"Health Affairs 20 (March/April 2001):9-18.For an overview of the role played by high-technology interventions in American health care in comparison to other countries,see Gerard F.Anderson,Uwe E.Reinhardt,Peter S.Hussey,and Varduhi Petrosyan," It's the Prices,Stupid:Why the United States is so Different from Other Countries," Health Affairs 22 (2002),89-105.
  • 2For discussions of the impact of the growing elderly population on health care costs,and other issues related to health care costs for the elderly,see Tim Miller,"Increasing Longetivity and Medicare Expenditures," Demography,Vol.38,No.2.(May,2001),pp.215-226;Uwe E.Reinhardt,"Health Care for the Aging Baby Boom," The Journal of Economic Perspectives,Vol.14,no.2 (Spring,2000):71-83;Dana P.Goldman and Julie M.Zissimopoulos,"High Out-of-Pocket Health Care Spending by the Elderly," Health Affairs 22 (May/June 2003):194-202;James R.Knickman,Kelly A.Hunt,Emily K.Snell,Lisa Maria B.Alecxih,and David L.Kennell,"Wealth Patterns Among Elderly Americans:Implications for Health Care Affordability," Health Affairs 22 (May/June 2003):168-173;Michael A.Morrisey and Gail A.Jensen,"The Near-Elderly,Early Retirees,and Managed Care," Health Affairs 20(November/December 2001):197-206;and James Lubitz,Linda G.Greenberg,Yelena Gornia,Lynne Wartzman,and David Gibson,"Three Decades of Health Care Use by the Elderly,1965-1998," Health Affairs 20 (March/April 2001):19-32.
  • 3For example,in a Cato Institute study of the economic effects of health care regulation in the United States "Health Care Regulation:A $ 169 Billion Hidden Tax," Policy Analysis No.527 (October 4,2004),Christopher J.Conover reports that" continuation-of-coverage mandates have a net cost of $ 15.0billion,while benefit mandates have a net cost of $ 13.5 billion" (p.13).In another Cato Institute study,John C.Goodman discusses some of the problems with proposed national health insurance schemes;see "Health Care in a Free Society:Rebutting the Myths of National Health Insurance," Policy Analysis No.532(January 27,2005).See also T.Barnighausen and R.Sauerborn," One Hundred and Eighteen Years of the German Health Insurance System:Are There any Lessons for Middle and Low-income Countries?" Social Science & Medicine 54(10) [May2002]:1559-1587.
  • 4See National Center for Policy Analysis,"NCPA Health Reform Plan" (January 9,1995,W16)excerpted from Briefing Book on Health Care,and adapted from John C.Goodman and Gerald L.Musgrave,Patient Power:Solving America's Health Care Crisis (Washington,DC:Cato Institute,1992).Available online at http://www.Ncpa.org/w/w16.html.Accessed 06/10/05.
  • 5For an overview of the Singapore health care system,see Healthcare Research Group,Health Services in Singapore:A Strategic Entry Report,1999 (San Diego,CA:Icon Group International,1999) and John Duff,"Financing to Foster Community Health Care:A Comparative Analysis of Singapore,Europe,North America and Australia," Current Sociology49,no.3 (2001):135-154.
  • 6John Graham," Perils of Parallel Trade:Reimporting Prescription Drugs from Canada to the U.S," in H.T.Engelhardt and J.R.Garrett,eds.Medical Innovation,Profit,and Bioethics (forthcoming).
  • 7The term bioethics was coined by Van Rensselaer Potter ("Bioethics,the Science of Survival," Perspectives in Biology and Medicine 14 [1970],127-53;"Biocybernetics and Survival," Zygon 5[1970],229-46;and Bioethics,Bridge to the Future [ Englewood Cliffs,NJ:Prentice-Hall,1971 ]).Potter sought to engender an ethos aimed at preserving the biosphere (Global Bioethics [ East Lansing:Michigan State University Press,1988])."Bioethics" appears to have been either independently coined or fundamentally recast in its meaning by Sargent Shriver and/or André Hellegers (Sargent Shriver,letter to author,January 26,2001).See also Warren Reich,"The Word 'Bioethics':Its Birth and the Legacies of Those who Shaped its Meaning," Kennedy Institute of Ethics Journal 4 (1994),319-336.An overview of the development of bioethics as the new health care morality is provided by Albert Jonsen,The Birth of Bioethics (New York:Oxford University Press,1998).
  • 8The difficulty in establishing a particular foundation so as to justify a particular moral perspective has been well known for nearly two thousand years.A classical account of these difficulties was provided by Agrippa,a member of the late Academy,who argued that it was impossible to resolve foundational philosophical disputes by sound rational argument.Agrippa took this position because of the centuries-old failure of philosophers to reach a consensus,as well as the circumstance that all argue from within a particular theoretical perspective,rendering competing views to some extent incommensurable.In addition and crucially,philosophical arguments at their foundations inevitably beg the question,argue in a circle,or engage in an infinite regress.Though one might dispute the strength of Agrippa's arguments regarding philosophy in general,the difficulty with regard to moral theory is that a different ranking of values and/or a different ranking of basic moral principles will ground a different morality.Any particular ranking of values and right-making conditions,any particular moral sense,depends on a particular background set of premises and rules of inference necessary to authenticate that ranking,which background premises and rules of inference could have been otherwise.Agrippa 's views are recorded by Diogenes Laertius (Lives of Eminent Philosophers Ⅸ.88) and Sextus Empiricus ("Outlines of Pyrrhonism" Ⅰ.164).For reflection on these difficulties,see Engelhardt,1996,chapter 2.
  • 9In his influential 1971 account of the theory of justice,it may not appear obvious to the casual reader that Rawls is not in fact establishing a particular moral vision.In his later works this becomes clear,as he takes the position that he is not providing a moral or metaphysical account,but rather an exegesis of the commitments involved in a particular social-democratic constitutional vision.John Rawls,A Theory of Justice (Cambridge,MA:Harvard University Press,1971),and Political Liberalism (New York:Columbia University Press,1993).For an example of an account grounded in a reading of John Rawls'A Theory of Justice as a moral text,see Normal Daniels,Just Health Care (Cambridge and New York:Cambridge University Press,1985).
  • 10For a more detailed analysis of the inescapably procedural character of any general secular morality,see H.T.Engelhardt,Jr.The Foundations of Bioethics,2nd ed.(New York:Oxford University Press,1996).

同被引文献7

引证文献1

二级引证文献2

中国医学伦理学
2006年 第1期

相关作者

内容加载中请稍等...

相关机构

内容加载中请稍等...

相关主题

内容加载中请稍等...

浏览历史

内容加载中请稍等...
;
使用帮助 返回顶部