社会医学和“红”“专”冲突

Social Medicine and the Conflict between“Red”and“Expert”

本文将毛泽东时代提高人口健康水平的经验置于社会医学的脉络中。社会医学认为,疾病既是一种生物学的现象,也是特定社会条件的结果,而且后者的影响更大。想要持久地提高人口的健康状况,需要推动政治层面的根本变革,不断消除疾病的社会根源。本文指出,毛泽东时代的特殊性在于,其不仅实践了社会医学的一般理念,还进一步思考了潜在的危机及应对方法。苏联和智利的案例证明,若不克服社会主义制度下“专”与“红”的矛盾,社会医学将难以为继。以赤脚医生为代表的制度设计,正是通过正式经济关系和非正式社会关系的安排克服“红”“专”冲突的有益尝试。20世纪80年代之后,中国的社会医学陷入停滞和退却,并不意味着之前探索的失败。在深化政治体制改革和突发公共卫生事件的双重背景下,重启社会医学的探索势在必行,而毛泽东时代的实践将为此提供坚实的本土经验基础。

This paper contextualizes the efforts to enhance population health during the Mao Zedong era within the framework of social medicine.Social medicine contends that illness is not solely a biological phenomenon but also a consequence of specific social conditions, with the latter affecting more. Achieving a sustained improvementin population health necessitates fostering fundamental political changes and consistently addressingthe social origins of illness. What sets the Mao Zedong era apart is its practical embodiment of the general tenetsof social medicine, coupled with a thoughtful consideration of potential crises and coping strategies. Cases fromthe Soviet Union and Chile underscore that without resolving the“red”and“expert”conflicts within the socialistsystem, the continuity of social medicine becomes precarious. The institutional design exemplified by“barefootdoctors”stands out as a pragmatic attempt to navigate the“red”and“expert”conflicts through arrangementsin both formal economic relations and informal social interactions. The apparent stagnation and retreat ofsocial medicine in China post-1980s should not be construed as a failure of prior explorations. Against the backdropof deepening political system reforms and the dual challenges posed by the political system and the COVID-19 pandemic, a resumption of exploration in social medicine becomes imperative. The practices of the MaoZedong era offer a robust foundation for indigenous experiences in this exploration.