健康水平平等追求與中國綱常倫理——基於中國醫療衛生體制改革進程的思考

Pursuit of Health Equality and the Cardinal Virtues in Chinese Ethics—Reflections on Chinese Health Care System Reform

Abstract

LANGUAGE NOTE | Document text in Chinese; abstract also in English.

中國傳統綱常蘊含著深刻的生命道德原則，發掘、認識和理解這一傳統倫理文化的核心內容，對認識和審視當代中國以追求社會健康水準平等為目的的醫療衛生體制改革具有重要的道德價值。如果說綱常倫理是根基，而與綱常倫理一脈相承的儒家生命倫理思想，則能夠為認識和解決醫療衛生體制改革的具體問題提供理論支援和邏輯分析框架。用“差等之愛”的思想分析醫保籌資制度便是例證。中國醫改八年成就斐然，社會健康水準平等應當成為醫改的目標指向，中國傳統綱常中保障生命安全和提供生命基本供養的思想，能夠成為醫改的道德原則和倫理智慧，而儒家生命倫理學則能夠將綱常倫理思想轉化為實在的方法與路徑。

Traditional Chinese ethics contain profound bioethical teachings and principles. For the purpose of understanding and reflecting on the ongoing health care system reform in mainland China in recent years, it is important to rediscover, recognize and understand the central teachings of traditional Chinese ethics, especially the cardinal Confucian virtues in Chinese traditions. It is implausible to pursue health equality for everyone, as individuals inevitably exhibit differences in their health conditions no matter what kind of health care system is maintained. However, it is plausible to accomplish health equality in the sense that everyone in society enjoys a similar public health care system. With the great achievements made during the eight-year process of health care system reform in China, health equality has rightly become the target of reform and been significantly improved. Following the cardinal Chinese ethical virtues and principles that advocate for both universal and differentiated/graded love, the Chinese reform should not only pursue health equality, but also allow individuals to pursue private insurance schemes for themselves and their family members to practice differentiated/graded love. The government should not only ensure equality of public insurance for everyone in Chinese society, but also leave sufficient room for individuals to purchase private insurance for better or quicker health care.

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