医改与政府责任的伦理思考

在归纳医改失败原因的主流性意见和分析典型案例的基础上,揭示：医改失败的根本原因是趋利性临床决策和泛企业化卫生政策,形成机制是二者的共同作用,实质是医疗卫生服务与广大人民群众日益增长的健康需求和经济发展水平的不相适应,其中折射出政府责任伦理主要方面的缺位、不到位和不作为;医疗卫生服务的基本目标是社会公众利益的最大化,这是医疗卫生服务领域中始终应占主导地位的价值取向,当然也是医改中政府责任伦理的正确取向.

Ethical Consideration about the Medical Health Reform and the Government Responsibility

Based on summing up the mainstream opinion of the reasons of the failure of medical health reform and analyzing typical cases,this article promulgates the following content.The medical health reform' s failure are due to the clinical decision-made in seeking interest and the health policy of exuding the commercialization.The forming mechanism is the two reasons work together.The essence is the medical health service is not suited to people's healthy demand which grows day by day and the level of economic development.This refracts the absentation of the government responsibility ethics,which does not present or work.The basic goal of the medical health service to maxi mize the public benefit,which is the dominant value orientation in the medical health service.Certainly it is also the right orientation of the government responsibility ethics in medical health reform.