Caplan A L, Priester R
Center for Biomedical Ethics, University of Minnesota.
Kennedy Inst Ethics J. 1992 Sep;2(3):201-15. doi: 10.1353/ken.0.0080.
Minnesota's recently enacted HealthRight legislation places the state at the forefront of American health reform. How did the state manage to overcome the policy gridlock in evidence in other states and at the national level? And how well does the legislation fare under close ethical scrutiny? Among the most important factors that permitted Minnesota to enact reforms were the explicit linkage in the legislative debate of the goal of cost containment to the desire to expand access, the public perception that HealthRight is incremental and consistent with earlier reform efforts in Minnesota, and the lengthy public debate that preceded the enactment of HealthRight. Although it endeavors to create a fair and efficient health care system, it is not at all certain that HealthRight, in its present form, will achieve these normative goals.
明尼苏达州最近颁布的《健康权法案》使该州在美国医疗改革中处于领先地位。该州是如何克服其他州以及国家层面存在的政策僵局的呢?在严格的道德审查下,这项立法效果又如何呢?明尼苏达州能够进行改革的最重要因素包括:在立法辩论中,成本控制目标与扩大医疗服务可及性的愿望之间有明确的联系;公众认为《健康权法案》是渐进式的,并且与明尼苏达州早期的改革努力相一致;以及在《健康权法案》颁布之前进行了长时间的公开辩论。尽管该法案致力于创建一个公平、高效的医疗体系,但目前形式的《健康权法案》能否实现这些规范性目标还完全不确定。