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我国医疗体制改革是在中国农村和城市全面改革的大背景下进行的。中国改革取得成功的深层动因是允许个人功利的追求。这一背景也深刻影响到了医疗体制改革。医疗体制改革的重要趋向就是医院的市场化。市场化使得医院几乎成为单纯商业化运作的事业,因而市场正义成为医疗公正的取向。这是医疗改革失败的深层精神原因。走出这一困境就必须加大政府投入,使得医院从市场正义回归社会公平的正义;并在克服商业化倾向的同时,还需要有人道主义精神的重建。
China’s medical system reform is carried out under the background of the comprehensive reform of rural areas and cities in China. The underlying reason for the success of China’s reform is the pursuit of personal utility. This background has also profoundly affected the medical system reform. The important trend of the medical system reform is the marketization of the hospital. Marketization makes the hospital almost become a mere commercial operation of the cause, so market justice has become the medical orientation. This is a deep spiritual reason for the failure of health care reform. To get out of this dilemma, we must increase government input, making the hospital return justice from the market to the justice of the society; and while overcoming the tendency of commercialization, we also need to rebuild the humanitarian spirit.