Kottow M
Departamento de Filosofía, Facultad de Filosofía y Humanidades, Universidad de Chile, Casilla 16168, Correo 09, Santiago, Chile.
Cad Saude Publica. 1999;15 Suppl 1:43-50. doi: 10.1590/s0102-311x1999000500006.
Justice in health care and the allocation of scarce medical resources must be analyzed differently in affluent as compared to economically weaker societies. The protective functions of the state must be extended to cover basic needs for those too poor to meet them on their own. Medical needs are a high priority, since poor health hampers the ability to secure other basic needs. The state may operate as either a health care provider or supervisor, guaranteeing that citizens be treated fairly by nongovernmental institutions. Two-tiered systems with a vigorous private heath care sector are compatible with the explicit right to health care, provided the private tier operates without directly or indirectly draining public funds.
与经济较弱的社会相比,在富裕社会中,医疗保健中的公平以及稀缺医疗资源的分配必须进行不同的分析。国家的保护职能必须扩大,以涵盖那些太穷而无法自行满足基本需求的人的基本需求。医疗需求是高度优先事项,因为健康状况不佳会妨碍获得其他基本需求的能力。国家可以作为医疗保健提供者或监管者运作,确保公民受到非政府机构的公平对待。只要私营部门的运作不会直接或间接耗尽公共资金,拥有活跃的私营医疗保健部门的双层医疗系统就与明确的医疗保健权相兼容。