社会分层与城乡医疗救助制度的思考

医疗救助是医疗保障制度的一个重要内容,然而,社会弱势群体的疾病医疗困境,学者和政府均重视不够.通过回顾梳理医改背景下的城乡医疗救助制度的建立和发展历史,分析现行医疗救助制度存在的主要问题,进而提出进一步完善城乡医疗救助制度的思路与对策.     

社会分层与城乡医疗救助制度的思考

医疗救助是医疗保障制度的一个重要内容,然而,社会弱势群体的疾病医疗困境,学者和政府均重视不够。通过回顾梳理医改背景下的城乡医疗救助制度的建立和发展历史,分析现行医疗救助制度存在的主要问题,进而提出进一步完善城乡医疗救助制度的思路与对策。     

关于在医疗机构中建立医疗救助制度的思考

医疗救助制度是医疗保障制度的一个重要组成部分,而医疗机构中的医疗救助制度则是社会医疗救助制度的一种补充形式。在分析我国医疗救助制度发展现状的基础上,提出了在医疗机构中建立医疗救助制度的构想,并对医疗机构中的医疗救助制度的性质以及建立医疗救助制度的必要性进行分析,进而对在医疗机构中建立医疗救助制度的几个关键问题进行了探讨。     

关于在医疗机构中建立医疗救助制度的思考

医疗救助制度是医疗保障制度的一个重要组成部分,而医疗机构中的医疗救助制度则是社会医疗救助制度的一种补充形式.在分析我国医疗救助制度发展现状的基础上,提出了在医疗机构中建立医疗救助制度的构想,并对医疗机构中的医疗救助制度的性质以及建立医疗救助制度的必要性进行分析,进而对在医疗机构中建立医疗救助制度的几个关键问题进行了探讨.     

第三方支付:医疗救助费用支付的福利经济学分析

医疗救助是为缓解贫困群体的医疗困境而制定的一项医疗保障制度.我国医疗救助在实施过程中多采用事后报销的救助方式,救助效果不甚明显.通过分析第三方支付所产生的福利影响,提出将第三方支付的费用支付方式引入到医疗救助中,以期发挥更大的救助效果.     

中美两国医疗救助模式比较分析

医疗救助作为保障贫困人群健康权的最后一道防线,在世界各国均备受关注.各国因国情的不同,医疗救助模式也大有不同.为进一步完善我国医疗救助制度,从救助对象的选择、救助项目、筹资及运作方式几个方面对中美两国医疗救助进行了比较分析.发现中美两国的医疗救助在救助对象的选择、救助项目、筹资及运作方式方面有所不同,而这些不同给我国医疗救助制度、模式乃至理念带来很多可借鉴之处,推动我国进一步完善医疗救助制度.     

第三方支付:医疗救助费用支付的福利经济学分析

医疗救助是为缓解贫困群体的医疗困境而制定的一项医疗保障制度。我国医疗救助在实施过程中多采用事后报销的救助方式,救助效果不甚明显。通过分析第三方支付所产生的福利影响,提出将第三方支付的费用支付方式引入到医疗救助中,以期发挥更大的救助效果。     

反贫困背景下我国医疗救助对象分类研究

从反贫困这一社会问题入手,突出医疗救助对象分类需要进一步完善的重要性,通过分类救助理论研究现状的探讨,对我国探索分类救助制度的现状进行了阐述,并分析了制约分类救助发展的因素,在此基础上,阐述了国际上实施医疗救助对象分类的成功经验和启示,并提出了我国在反贫困背景下医疗救助对象分类的对策建议。     

医疗救助公平性的多维度审视

公平不仅是基本医疗服务的重要价值,也是国家治理和社会治理的首要目标。以医疗救助制度为研究对象,从公平的角度阐述我国医疗救助追求的公平价值的内涵,探讨社会救助制度的机会公平、过程公平、结果公平,构建出包括权利的可享有性、资金的可获得性、地理的可接近性、资源的可适用性、方式的可协调性、流程的可操作性、健康的可信赖性、经济的可承受性、制度的可持续这九个维度的指标体系。这一指标体系不仅为评价医疗救助制度提供了一个新的视角,而且也提供了推进医疗救助制度完善的路径设计。     

农村医疗救助的目标探讨

为探讨新形势下农村医疗救助制度目标机制的设计,提高制度靶向的准确性及效果,利用定性分析方法,结合医疗救助制度的功能分析,对现阶段该制度的目标对象及纳入依据进行了分析.研究认为,农民的医疗需求具有必需品性质,救助的水平以新农合为基本依托,同时,农村城镇化发展带来新的弱势人群的医疗保障问题提示,需因时、因地、因阶段设计医疗救助制度目标人群的纳入机制,提出按城乡划分、按阶层划分、按收入划分作为目标机制设计的依托是解决当前农村救助制度不公平问题的有效方式.     

高校学生医疗保障制度改革的设想：目标、原则与模式

提出了高校学生医疗保障制度改革的目标是建立与我国经济发展水平相适应的新的医疗保障制度,指出改革应遵循公平、责任共担和强制性等原则,并构建了以社会基本医疗保险为基础,以医疗救助和补充医疗保险为辅助的高校学生医疗保障新模式。     

Assessment through the dialectic: the necessary forgotten link.

Traditional assessment procedures focus on diagnosing psychopathology, thereby implicitly endorsing the medical model. It is equally vital to assess the nonpathological side of the person, the part that strives for increased personal satisfaction and impels the individual to seek psychotherapy. A dialectically based assessment would evaluate both the healthy and unhealthy forces in the person. Such an evaluation would address the nature and extent of participants' experienced pain, the degree to which participants are open to external assistance, and the style of assistance best suited for each individual.     

Welfare, Work Requirements, and Dependant-Care

abstract This article considers the justice of requiring employment as a condition of receiving public assistance. While none of the main theories of justice prohibits work requirements, the arguments in their favour are weak. Arguments based on reciprocity fail to explain why only means‐tested public benefits should be subject to work requirements, and why unpaid dependant care work should not count as satisfying citizens’ obligations to reciprocate. Arguments based on promoting the work ethic misattribute recipients’ nonwork to deviant values, when their core problem is finding steady employment consistent with supporting a family and meeting dependant care responsibilities. Rigid work requirements impose unreasonable costs on some of the poor. A welfare system based on a rebuttable presumption that recipients will work for pay, conjoined with more generous work supports, would promote justice better than either unconditional welfare or strict requirements [ 1 ].     

Relationship Quality among Chronically Ill Children and their Parents

The present study examined the quality of parent–child relationships as reported by 383 parents of chronically ill children. The medical condition category, child’s mobility, education type and childcare assistance were examined. Parents answered the Parent–Child Relationship Inventory (PCRI). In addition, 45 parents of chronically ill children were interviewed. The results indicated a significant difference in most aspects of the PCRI (limit setting, promotion of autonomy, communication, satisfaction and involvement) across medical condition categories. Further child variables (mobility, assistance and education type) had an effect on the PCRI subscales as well. Interview analysis revealed a difference in the reported quality of parent–child relationships between medical conditions categories. Parents of mentally ill children primarily felt anger and guilt in their relationship with their ill children, whereas parents of children with cancer and autoimmune disease primarily felt depressed. Our results suggest the need for further study of parent–child relationships in and between different chronic childhood medical conditions in an attempt to address parents’ and children’s needs in an optimal way.     

国家卫生财政政策补助对象的顺序选择

论述了国家卫生财政政策补助对象的选择问题,公共卫生服务物品提供机构与医疗服务物品提供机构之间的选择、医疗机构与患者之间的选择、公共卫生服务物品提供机构与居民之间的选择以及医疗机构与医生之间的选择,提出了卫生财政政策补助对象的选择顺序,公共卫生服务物品生产和分配机构,医疗保障机构,患者,医生,医疗机构。     

清末北京首家官立医院

1902年,北京发生霍乱,死亡无数。为了救助贫民和乞丐,清政府成立临时的医疗机构——北京官医局。1903年,北京官医局变成常设医疗机构——医院。北京官医局是北京的首家官立医院,1901年实行新政后,清政府开始改良医学,重要措施之一即是设立官办医院,后来逐渐成为民众医疗的主体。     

Autonomy and the refusal of life-prolonging therapy

Conclusion Autonomous decision-making over therapy options is not reducible to the refusal of unwanted medical intervention. This is a myth that has been imported from questionable assumptions in political economy, and is of little benefit to medical practice and the sometimes agonizing decisions which have to be taken by patients and their relatives. An individual's right to therapy abatement can be protected from abuse only in the context of a full understanding of autonomous choice; not merely the right to refuse, but the opportunity to receive assistance and consider alternatives. Limits are also required on the role of the surrogate in the refusal of therapy. Policies endorsing therapy abatement and exercise of the right to forego life-sustaining therapy should carry cast iron guarantees that they will not be disadvantageous to the poor and undereducated members of society. It should also be noted that fears of unlimited life-prolongation have been greatly exaggerated. In an atmosphere of governmental indifference to the plight of the sick, with the notion of welfare tuned to market forces, there is a danger that self-determination can have a restricted meaning; the option of death in the context of an underfunded health service. This may not be the time to campaign for the right to refuse therapy, but rather the time to campaign for improvements to existing therapy.     

心理贫困：概念、表现及其干预

长期物质贫困产生特殊的心理后果——心理贫困。心理贫困指的是不利于贫困阶层摆脱贫困的心理与行为模式,主要表现为 “志向失灵”与“行为失灵”,即抱负与志向缺位,理念和意识扭曲,能力与行为方式错位,还易于做出不利于脱贫的决策行为;长此以往,就陷入“贫穷—特定心理与行为模式—继续贫穷”的恶性循环。对此,研究者们先后开发了有条件现金转移项目、减少认知资源损耗项目、“转移和坚持”心理干预策略、社会阶层流动信念干预策略、公平感提升策略等干预方案。该领域研究及其相关成果对“精准”扶贫,促进社会公平、增加人类福祉具有重要意义。未来研究应在整合的干预方案和本土化的干预方案等方面予以加强。     

心理贫困：概念、表现及其干预

长期物质贫困产生特殊的心理后果——心理贫困。心理贫困指的是不利于贫困阶层摆脱贫困的心理与行为模式,主要表现为 “志向失灵”与“行为失灵”,即抱负与志向缺位,理念和意识扭曲,能力与行为方式错位,还易于做出不利于脱贫的决策行为;长此以往,就陷入“贫穷—特定心理与行为模式—继续贫穷”的恶性循环。对此,研究者们先后开发了有条件现金转移项目、减少认知资源损耗项目、“转移和坚持”心理干预策略、社会阶层流动信念干预策略、公平感提升策略等干预方案。该领域研究及其相关成果对“精准”扶贫,促进社会公平、增加人类福祉具有重要意义。未来研究应在整合的干预方案和本土化的干预方案等方面予以加强。