Stone Deborah
Dartmouth College, USA.
J Health Polit Policy Law. 2006 Feb;31(1):127-52. doi: 10.1215/03616878-31-1-127.
Although racial and ethnic disparities in health have been on the federal government's agenda since 1985, no policy reforms have significantly reduced disparities. The question arises whether states can effectively address this issue without waiting for solutions from the national government. The purpose of this article is to propose ways of reframing the disparities issue that might give state policy makers more leverage and might strengthen political will to address the issue. I suggest a moral frame based on a concept of distributive justice in which medical care must be distributed according to need. I explain the rationales for such a frame and consider its strategic advantages and disadvantages. In the last section, I suggest some policies based on this framing that are within the power of state legislatures.
尽管自1985年以来,健康方面的种族和族裔差异问题就已被列入联邦政府的议程,但没有任何政策改革显著缩小了这些差异。问题在于,各州能否在不等待国家政府解决方案的情况下有效解决这一问题。本文的目的是提出重新构建差异问题的方法,这可能会赋予州政策制定者更多影响力,并可能增强解决该问题的政治意愿。我建议基于分配正义概念构建一个道德框架,在这个框架中,医疗保健必须按需分配。我解释了这种框架的基本原理,并考虑了其战略优势和劣势。在最后一部分,我提出了一些基于这种框架且在州立法机构权力范围内的政策。