The rights of the medically uninsured: an analysis of social justice and disparate health outcomes.

Michelle Chandler
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引用次数: 9

Abstract

As technological advances in the United States continue to improve the effectiveness of medical interventions, expectations among Americans of both improved health and extended life expectancy have also increased. At the same time, many of the population continue to lack the insurance necessary to access even the most basic healthcare services (Institute of Medicine, 2004; Tunzi, 2004; Saha & Bindman, 2001). With approximately 18,000 avoidable deaths attributed annually to inadequate medical coverage and 43.6 million individuals currently without insurance benefits, the need to address the disparity in access to treatment and a means of social justice in the distribution of health care is all too clear (Crispen & Whalen, 2004). As a nation relying on market mechanisms to regulate the costs and quality of available health resources (Baldor, 2003; Saha&Bindman, 2001), the welfare of society as a whole may soon be threatened by the provision of marginal services to a select minority as increasing numbers of the uninsured continue to experience less favorable clinical outcomes and higher mortality rates (Tunzi, 2004; Litaker & Cebul, 2003; Jackson, 2001; Sox, Burstin, Edwards, O'Neil et al., 1998). The author will first examine the consequences of being among the growing number of uninsured individuals in the United States. Attention will then be given to exploring the social justice issues inherent in this critical problem and evaluating these issues through the perspective of both libertarian and feminist theory. Using these theories, innovative strategies for attaining distributive justice in the provision of health care will be offered with recommendations for utilizing these alternative approaches to develop and implement future health policy.

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医疗上没有保险的人的权利:对社会公正和不同健康结果的分析。
随着美国的技术进步不断提高医疗干预措施的有效性,美国人对改善健康和延长预期寿命的期望也有所提高。与此同时,许多人仍然缺乏获得最基本保健服务所需的保险(医学研究所,2004年;Tunzi, 2004;Saha & Bindman, 2001)。每年约有18 000例本可避免的死亡是由于医疗覆盖不足造成的,目前有4 360万人没有保险福利,因此很明显,有必要解决在获得治疗方面的差距问题,并在医疗保健分配方面实现社会公正(Crispen & Whalen, 2004年)。作为一个依靠市场机制来调节可用卫生资源的成本和质量的国家(Baldor, 2003;Saha&Bindman, 2001),整个社会的福利可能很快就会受到向少数人提供边缘服务的威胁,因为越来越多的没有保险的人继续经历不太有利的临床结果和更高的死亡率(Tunzi, 2004;Litaker & Cebul, 2003;杰克逊,2001;Sox, Burstin, Edwards, O'Neil et al., 1998)。作者将首先检查的后果是越来越多的没有保险的个人在美国。然后,我们将重点探讨这个关键问题中固有的社会正义问题,并通过自由意志主义和女权主义理论的视角来评估这些问题。利用这些理论,将提出在提供卫生保健方面实现分配公正的创新战略,并提出利用这些替代办法制定和执行未来卫生政策的建议。
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