救援與責任: 學會在限制中生活
Of Rescue and Responsibility: Learning to Live with Limits
DOI:
https://doi.org/10.24112/ijccpm.21362Keywords:
柯林頓醫療計畫, 限額分配, 求援規則Abstract
LANGUAGE NOTE | Document text in Chinese
醫療保健權利的普遍化仍然是個夢想,尚未成為現實。部分原因在於求援規則(rule of rescue),促使我們救援身處困境的人,因而令我們忽視保健政策的限制,只要政策很可能損及特定的個人。由於救援規則動搖了我們對保健權利的限制,因而可能防礙了我們對成本之控制。但成本控制卻又是擴大保健取得之關鍵。因此,我們至今的做法,不是接受無限制的保健支出,而是拒絕將保健權利普遍化。這種情形日益惡化,因為病人和醫生得到保護,不受到保健成本在經濟上的影響,甚至都認為保健乃是免費的、是一項無限制的權利。為了扭轉這種花大錢的權利心態,並對求援有合理的限制,成們必須讓病人體會到其保健決策的某些後果,從而為其保健成本承擔更大的責任。有好些方法可以用來達成這項目標,而無須對所需要的保健設下經濟的障礙,或對病患形同懲罰。
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