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美国单一支付者医疗系统模式的基于价值观的基础。

Values-Based Foundation for a U.S. Single Payer Health System Model.

作者信息

Markowitz Walter, McLeod-Sordjan Renee

机构信息

School of Health Professions, School of Nursing, Hofstra University, Hempstead, NY, United States.

出版信息

Front Sociol. 2021 Apr 28;6:627560. doi: 10.3389/fsoc.2021.627560. eCollection 2021.

Abstract

A universal, single payer model for the American health system aligns with and should emanate from commonly held values contained within the country's foundational religious teachings, morals, ethics and democratic heritage. The Affordable Care Act in its attempt to create expanded health access has met with significant challenges. The conservative Supreme Court decreases the likelihood of a federal mandated single payer model. As uncertainty of the structure of the healthcare system increases, this paper supports its transformation to a single payer model. Healthcare should be considered a duty within the framework of a Kantian approach to ethics and a social good. Evidently ignoring this duty, the American health system perpetuates a healthcare underclass, with underserved portions of the population, with unequal access to quality care and persistent health status and outcome disparities. The COVID-19 pandemic demonstrated the effect of social determinants on optimal health outcome. A health insurance system based on the nation's commonly held values has the potential to eliminate these disparities.

摘要

美国医疗体系的全民单一支付者模式与该国基本宗教教义、道德、伦理和民主传统中所包含的共同价值观相一致,且应源于这些价值观。《平价医疗法案》试图扩大医疗覆盖范围,但面临重大挑战。保守派占多数的最高法院降低了联邦强制推行单一支付者模式的可能性。随着医疗体系结构的不确定性增加,本文支持将其转变为单一支付者模式。在康德伦理学方法和社会公益的框架内,医疗保健应被视为一项义务。显然,美国医疗体系忽视了这一义务,使得医疗保健弱势群体长期存在,部分人群得不到充分服务,获得优质护理的机会不平等,健康状况和结果的差距持续存在。新冠疫情证明了社会决定因素对最佳健康结果的影响。基于国家共同价值观的医疗保险体系有潜力消除这些差距。

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