Fenton Elizabeth
Institute for Practical Ethics and Public Life, University of Virginia, PO Box 400800, Charlottesville VA 22904, USA.
N Z Med J. 2011 May 13;124(1334):89-96.
The funding of expensive new cancer treatments is a difficult health policy issue in New Zealand and around the world. Since the public health system cannot afford to fund every new treatment, complex decisions must be made about which treatments to fund publicly, and whether and how to make unfunded treatments available to people who may wish to fund them themselves. One recent proposal is that unfunded treatments be made available to patients privately through the local public hospital. Although ultimately declined by the health minister, this proposal merits serious debate, since it is likely to continue to attract attention as a policy option. While the integration of public and private delivery systems has clear benefits for patients with the means to purchase additional treatments, its overall effect may be to exacerbate existing inequities in the New Zealand health sector. This paper briefly explores the wider ramifications of such schemes as part of the ongoing public discussion that should inform the development of health policy on this issue.
在新西兰乃至全世界，为昂贵的新型癌症治疗方法提供资金都是一个棘手的卫生政策问题。由于公共卫生系统无力为每一种新疗法提供资金，因此必须做出复杂的决策，决定哪些疗法由公共资金资助，以及对于那些可能希望自费购买未获资助疗法的人，是否以及如何提供这些疗法。最近有一项提议，即未获资助的疗法可通过当地公立医院向患者私下提供。尽管该提议最终被卫生部长否决，但仍值得认真辩论，因为作为一种政策选择，它可能会继续受到关注。虽然公私医疗体系的整合对有能力购买额外治疗的患者有明显好处，但其总体效果可能会加剧新西兰卫生部门现有的不平等现象。本文简要探讨了此类计划更广泛的影响，作为正在进行的公众讨论的一部分，这些讨论应为该问题的卫生政策制定提供参考。
