Mhatre S L, Deber R B
Department of Health Administration, University of Toronto, Ontario, Canada.
Int J Health Serv. 1992;22(4):645-68. doi: 10.2190/UT6U-XDU0-VBQ6-K11E.
Having achieved equality of access to health care, Canadian policymakers are setting new policy goals, within resource constraints, primarily to achieve equity of access to health. Across the country, provincial royal commissions have explored a number of policy options to achieve this goal. These options are reviewed and critically analyzed within the context of such challenges in health policy as insufficient access to high-technology care and the limits of medical care, and such external challenges as economic and demographic trends, federal-provincial disputes, and ideological beliefs. Particular attention is given to the implications of a broader definition of health and the concept of regional health authorities. Based on the provincial reviews, the authors conclude that Canada wants to achieve equitable access to health. With the shift of health policy away from the formerly protected arena of medical care, achieving equitable access to health will require both an alteration of priorities and values and considerable political will. Canada will be forced to meet these new challenges to maintain current achievements and to make its system even more successful.
在实现了医疗保健服务可及性平等之后，加拿大政策制定者在资源限制范围内设定了新的政策目标，主要是为了实现医疗服务可及性的公平性。在全国范围内，省级皇家委员会探讨了多种政策选项以实现这一目标。这些选项在诸如高科技医疗服务可及性不足和医疗保健局限性等卫生政策挑战，以及经济和人口趋势、联邦与省级争端和意识形态信仰等外部挑战的背景下进行了审查和批判性分析。特别关注了更广泛的健康定义和区域卫生当局概念的影响。基于省级审查，作者得出结论，加拿大希望实现医疗服务的公平可及。随着卫生政策从以前受保护的医疗保健领域转移，实现医疗服务的公平可及将需要优先事项和价值观的改变以及相当大的政治意愿。加拿大将被迫应对这些新挑战，以维持目前的成就并使其医疗体系更加成功。
