我国宏观卫生政策理论与实践研究概述

从宏观卫生政策的理论入手，对卫生政策的理论支撑体系进行了较详尽的论述，对我国建国以来的宏观卫生政策的实践及政策效应进行了客观的分析，特别是对未来宏观卫生政策的理论支撑及选择、宏观卫生政策的政策取向提出了一些可供参考的建议。     

宏观卫生政策的经济学思考

用宏观经济学来分析卫生政策是我们观察全球发展和健康问题的一个新的视角。对我国而言，宏观经济出现了前所未有的发展契机，对宏观卫生政策提出了新的要求一如何使宏观卫生政策适应新的宏观经济环境是我们目前所面临的重要问题之一。     

规范基层医院股份合作制需亟待解决的宏观问题

在我国城乡,基层医院的股份合作制改革虽然尚处于探索阶段,但可以预期,随着市场经济体制的逐步确立和卫生改革的不断深化,已经改制了的医院的做法与经验会在更大的空间产生较强的示范效应。一些基层医院选择股份合作制等形式的产权制度改革将是不能回避的。现在,从宏观的管理层面上看,面临的主要问题,已经不是讨论基层医院可否实行股份合作制的时候了,而是如何面对现实,积极规范基层医院的改制行为问题。由于因宏观卫生政策的调整受益不如大医院多,基层医院在产权制度改革方面表现了较强的动机,改制的动作也比较快。目前,选择股…     

宏观卫生政策的政治学思考

用政治学理论来分析宏观卫生政策，是宏观卫生政策分析中的一个新的角度。有利于更加全面地指导宏观卫生政策的制定和实施。通过回顾我国政治传统与发展，分析我国政治传统与发展以及我国现代政治学理论对宏观卫生政策的影响。揭示出政治学对宏观卫生政策的潜在的易被忽略的巨大影响力。     

新时期宏观卫生政策的取向

从新时期卫生工作的角度，对未来宏观卫生政策的政策取向进行一些有益的探讨：新时期应首先确立“人民健康福利优先”的思路．政府的公共卫生政策应投资于人民健康，宏观经济政策应有利于提高人民健康水平；建立与完善卫生服务体系，加强与提高公共卫生的社会职能；指导思想应坚持以人为本，协调、全面和可持续发展的科学发展观；坚持改革开放，适应社会主义市场经济发展要求；坚持以预防为主，以农村为重点，为人民群众提供良好的医疗卫生服务；开放医疗市场，吸收国内外资金、技术和卫生管理经验，发展卫生事业、对宏观卫生政策的基本思路和重点领域也进行了有益的探索。     

卫生政策学刍议

一、卫生政策学的涵义及其作用政策,是一定时期内国家为实现既定的宏观目标所选择的管理手段。对政策的承受者来说则是其行动的准则。我国卫生政策学是研究社会主义制度下卫生政策的理论依据,卫生政策的产生、发展、配套设计和具     

功利主义在卫生决策中的应用

卫生政策决定着整个卫生系统的运行,卫生政策决策者的价值取向决定着卫生政策决策的方向、过程和结果。功利主义作为一种以人们行为的功利效果为道德准则的基本评价标准,是当今公共政策决策的基本原则之一,在卫生资源有限的情况下,卫生政策决策者通常坚持功利主义的价值导向,追求卫生资源的健康效益最大化。本文从伦理学的角度,探讨了功利主义在我国卫生政策决策背后的运用及其在卫生政策决策实践中的一些困境,以期增进卫生管理者和卫生政策分析者对卫生决策过程的理解。     

什么是"好"的卫生政策

医药卫生体制改革已进入攻坚和关键阶段,宏观、前瞻、科学的卫生政策指导与深厚社会关怀、社会健康理论支持已成为继续深化卫生体制改革发展战略措施和战略议题。如何科学民主决策,如何创造性地制定优秀的卫生政策框架,是卫生改革发展成功的前提。     

确定目标人群是卫生政策伦理道德的基本问题

目前,我国尚处于社会主义初级阶段,卫生事业供需矛盾仍较突出。因此,确立目标人群是制定卫生政策首先遇到的最重要也是最基本的道德问题。我们把制定卫生政策直接或间接指向一定区域的人群称作卫生政策的日标人群。日标人群,从价值指向人群范围的大小来讲,它有宏观和微观的区别,如纲领性卫生政策什1·划生育、初级卫生保健)中涉及的日标人群范围大,是宏观目标人群;而一些具体的决策,如公费医疗     

我国卫生改革与发展应坚持的价值观和伦理原则

卫生经济问题无一不具有道德成分，无一能离开伦理政策得以解决。我国卫生改革一开始就缺乏伦理基准，医疗服务过度市场化倾向、政府责任不到位和伦理缺席已将卫生改革引向功利主义的死胡同，使得卫生改革背离了公正目标。我们要正确认识市场的目标、价值和规律，正确理解和发挥政府和市场的调节作用，促进卫生改革的健康发展。在对我国卫生改革的伦理学展望中，我们提倡一种“公平优先，兼顾效率”的价值观。     

政府干预卫生领域的研究

政府是否应该对卫生领域进行干预，以及在多大程度上进行干预，是卫生经济学理论中长期探讨的一个问题。系统地分析了政府干预卫生领域的理论依据、干预手段的综合运用、政府干预的失败教训以及在卫生领域应该如何发挥计划、市场的积极作用，合理配置、利用卫生资源，加强科学管理，实现市场与政府的优化组合：结合目前对政府职能的重新界定，提出合理的建议。     

我国财政体制对公共卫生补偿政策的影响

新的财政体制在我国已经施行了整整10年。在这10年里，我国的公共卫生补偿政策出现了哪些变化，新的财政体制到底对我国的公共卫生补偿政策产生了什么样的影响以及今后我国对公共卫生补偿的改革方向是什么样的，是本文想要阐述的主题。     

新医改背景下加强公立医院医药费用控制体系建设的思路探讨

控制医药费用的不合理上涨,缓和“看病贵、看病难”的社会矛盾,一直是卫生政策的重要着眼点。医疗费用快速增长的不合理因素主要是由于医疗卫生机制不完善造成的,如医疗服务补偿机制、医院运行机制、医疗保险付费机制和医疗卫生筹资机制等。因此,体系的建立将对医药费用的控制起到积极作用,控制医疗费用快速增长既要建立新型卫生服务体系,加强政府宏观管理,理顺补偿机制,也要改革医院运行机制。     

Health Activism Targeting Corporations: A Critical Health Communication Perspective

Health activists and health social movements have transformed medical treatment, promoted public health policies, and extended civil rights for people with illness and disability. This essay explores health activism that targets corporate-generated illness and risk in order to understand the unique communicative challenges involved in this area of contention. Arguing for greater critical engagement with policy, the article integrates policy research with social movements, subpolitics, and issue management literature. Drawing from activist discourse and multidisciplinary research, the article describes how a wide array of groups groups build visibility for corporate health effects, create the potential for networking and collaboration, and politicize health by attributing illness to corporate behaviors. The discussion articulates the implications of this activism for health communication theory, research, and practice.     

The unbearable lightness of citizens within public deliberation processes

There is a growing literature examining the involvement of citizens in health policymaking. While determining what form such involvement should take and who should participate is of particular interest to policymakers and researchers, the current ontological understanding of what a citizen is suffers from "lightness." This essay thus seeks to provide more depth by shedding light on the ways in which individuals define what "being" a citizen means for them and choose to embody or not such a role. Inspired by a four-year ethnographic study of a Canadian science/policy network in genetics, which integrated citizens into its operation, this paper provides four biographical sketches that portray the complexity and richness of what these individuals were "made of." We reflect on how they sought to make sense of their participation in the network by drawing on a repertoire of cultural, relational and cognitive resources and on their lived experience. Their capacity to "be" a participant and to be acknowledged as such by the others was shaped by their values and interests and by the contributions they sought to realise throughout their participation. Our discussion suggests that the quest for the "ordinary" citizen is misleading. Instead, acknowledging the sociological concreteness of citizenship and understanding how it may be embodied and exercised should be a key focus in public involvement theory and practice in health care.     

Building an inter-disciplinary science of health inequalities: the example of lifecourse research

Across the post-industrial world, new public health strategies are being developed with the goal of reducing the socio-economic gradient in health. These new strategies are distinguished by a commitment to tackling the macro determinants of health inequalities through policies informed by scientific evidence. The engagement with macro determinants and with scientific evidence presents a major challenge to the health inequality research community. This is not only because of the complexity of the links between distal causes, proximal risk factors and health outcomes. It is also and more importantly because of the narrow disciplinary base of health inequality research. Grounded in social epidemiology, health inequality research has illuminated the pathways which run from individual socio-economic position to health-but has left in shadow the factors which influence socio-economic position. Broadening the evidence base to include these structural processes requires a new science of health inequalities, resourced both by epidemiological research and by research on social inequality and social exclusion. The paper demonstrates how such an inter-disciplinary science can be constructed. Taking lifecourse research as its example and the UK as its case study, it nests epidemiological research within social policy research: setting evidence on the health consequences of cumulative exposures within research on lifecourse dynamics, and locating both within analyses of how state policies can amplify or moderate inequalities in socio-economic position.     

Dietary Guidelines for Americans, 1990 edition

The Dietary Guidelines for Americans are the federal statement of dietary guidance policy. The small bulletin presenting the guidelines contains practical advice for healthy Americans about what constitutes a healthful diet and how such a diet is important to health. The guidelines bulletin was first published in 1980 and revised slightly in 1985. The third edition (1990) reflects new research on diet and health relationships and on the utility of the guidelines to the public. The 1990 guidelines are: Eat a variety of foods; maintain healthy weight; choose a diet low in fat, saturated fat, and cholesterol; choose a diet with plenty of vegetables, fruits, and grain products; use sugars only in moderation; use salt and sodium only in moderation; and if you drink alcoholic beverages, do so in moderation.     

Slaying sacred cows: is it time to pull the plug on water fluoridation?

Water fluoridation continues to be a contentious public health policy. Recent moves to introduce schemes in England raise important questions about the use of evidence in public policy. Of particular concern is how evidence is used for public health policy-making purposes. This article reviews some of the key debates about water fluoridation and examines the way evidence has been promoted and used. The background to water fluoridation is discussed and also key ideas about how evidence influences policy. While traditionally the problem of evidence is characterised as one where policy makers either accept or ignore evidence, a central concern of this article is where poor evidence is promoted by professionals and accepted by policy makers. The article then examines the evidence on the effects of water fluoridation. Drawing on the idea of the ‘Gold Effect’, the article shows how deeply held beliefs about public health actions shape not just policy but also the application of evidence itself by professionals and researchers.