罗尔斯正义论对我国基本医疗卫生服务改革公平性的启示

Enlightenment of Rawls' Theory of Justice on Basic Medical Care and Health Service Reform in China

本文以罗尔斯的正义论为视角,结合医疗公平和健康公正分析其无知之幕下的原初状态,以及两个正义原则,即公平原则、差别原则所蕴含的思想内涵,阐释罗尔斯对社会基本品公平分配的相关思考。在此基础上结合我国新医改实际,提出当前我国基本医疗卫生服务改革的公平性应以平等观念为基本价值导向,以机会和程序公平作为机制保障,注重健康责任的公平合理分担,关注贫困地区、弱势人群的健康,以促进医疗卫生服务分配和利用的公平性。

From the perspective of RaMs＂ theory of justice, this paper analyzes the ideological essence of original position un- der the viel of ignorance and the principle of equality and the principle of difference linked with medical fairness and health justice to explain Rawls＂ thinking of fair distribution of social primary goods. Based on these analysis and the reality of China＇ s new basic health reform, the authors propose that equity of the reform should be guided by equality as the basic value orientation, be guaran- teed by opportunity equity and procedure justice, focus on sharing health responsibility fairly and compensate more for the health of impoverished population and vulnerable groups to promote utilization of health care equitably.