集体的责任——中国当代医疗改革的责任伦理学剖析之二

The Responsibility of Unit——Responsiblity Ethics Analysis of Modern Health Reform Policy in China (2)

医院是卫生保健共同体的核心;未来医院应分为特级医院、高级医院、中级医院与社区医院4类;医疗机构应逐步强调成本和质量。初级卫生保健是卫生服务的重点内容;全科医师制度应进一步发展为初级保健全科医师中心,它与地区卫生局共同形成卫生服务的中间购买者。企业和顾主在医疗卫生制度改革中有着重要作用;企业在开销按保险规定的额度时应坚持一视同仁;任何集体都不可拒付应缴纳的那部分保险费,特别对于每月收入低于基本线的职工,医疗保险费应全部由集体承担。医院的主人永远不应成为市场中“惟利是图的商人”。

The hospital is the core of the health care community. The future hospitals should be made of special-class hospitals, advanced hospitals, middle-class hospitals and community hospitals. The cost and the quality of medical organizations should be emphasized step by step. The primary heath care is the pivot of health service. The general practitioner system should be developed into the primary health care center of general practitioners. Together with the local board of health, it should become the mid-purchasers of heath service. The enterprise and the clients play very important role in health policy reform. The enterprise should treat the employees equally without discrimination when dealing with the spending according to the insurance. No orgnizations or groups could refused to pay suitable part of the insurance fee for their employees, especially for those whose salary below basic income. The gnization should pay all of the insurance fee for those people. The host of the hospital should never become merchants who only care for money.