Health Care Reform: Practical and Reasonable Choices
Keywords:衛生保健改革目標, 雙層或多層服務體制, 配給, 救援
LANGUAGE NOTE | Document text in Chinese; abstract also in English.
Health care costs soar and become unbearable everywhere in the world. This is not only a problem faced by developed Western countries. It is also a difficult issue for the third world countries such as China. China's health care system needs reform. On the one hand, a great number of people have not been covered by any basic health insurance. On the other hand, however, critical care medicine in high-technology hospitals in urban areas consumes tremendous public health care resources for a very small group of patients. This essay argues that China should appropriately establish multiple goals for its health care reform, based on ethical and reasonable deliberations on China's actual health care situation.
First, rationing is crucial in containing health care costs. Public health care resources are limited. It is impossible to satisfy all medical needs for all people at all times. This is especially the case for mainland China, where public resources that can be invested in medical care are scarce. An appropriate goal of China's health care reform should be to provide basic, not luxury, health care for the people. Some luxury medical procedures must be left to individuals for purchase through their own resources.
Second, a basic level of health care must be ensured to most people, even if it is impossible to ensure to everyone. It is important for everyone to understand that providing the best care for everyone is practically impossible. The best a government can do is to provide some level of basic care. However, the goal here must be the basic health of all or most people, rather than total care for a small group of people.
Third, an appropriate pattern of China's health care should be prevention-oriented and ordinary-treatment-oriented, rather than high-technology-medicine-oriented. Since the early 1980s, many hospitals have relied on high-technology medicine to deal with diseases and to earn more income for themselves at the same time. But high-technology medicine is not panacea, though it is extremely costly. Inexpensive medical prevention is often more effective than high-technology medical procedures.
Finally, a rule of rescue should be established in society. Society ought to provide some help for those who need special expensive medical care (such as organ transplantation) and are not able to afford it. The rule of rescue guides our efforts in this direction. Society should organize and establish special foundations to help people in this regard.
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Copyright (c) 1999 International Journal of Chinese & Comparative Philosophy of Medicine
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