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  3. The problem of how health-care resources should be allocated or apportioned, so that they are distributed in both the most just

The problem of how health-care resources should be allocated or apportioned, so that they are distributed in both the most just

admin2014-12-26  79
问题     The problem of how health-care resources should be allocated or apportioned, so that they are distributed in both the most just and most efficient way, is not a new one. Every health system in an economically developed society is faced with the need to decide(either formally or informally)what proportion of the community’s total resources should be spent on health-care; how resources are to be apportioned; what diseases and disabilities and which forms of treatment are to be given priority; which members of the community are to be given special consideration in respect of their health needs; and which forms of treatment are the most cost-effective.
    What is new is that, from the 1950s onwards, there have been certain general changes in outlook about the finitude of resources as a whole and of health-care resources in particular, as well as more specific changes regarding the clientele of health-care resources and the cost to the community of those resources. Thus, in the 1950s and 1960s, there emerged awareness in Western societies that resources for the provision of fossil fuel energy were finite and exhaustible and that the capacity of nature or the environment to sustain economic development and population was also finite. In other words, we became aware of the obvious fact that there were "limits to growth". The new consciousness that there were also severe limits to health-care resources was part of this general revelation of the obvious. Looking back, it now seems quite incredible that in the national health systems that emerged in many countries in the years immediately after the 1939-1945 World War, it was assumed without question that all the basic health needs of any community could be satisfied, at least in principle; the "invisible hand" of economic progress would provide.
    However, at exactly the same time as this new realization of the finite character of health-care resources was sinking in, an awareness of a contrary kind was developing in Western societies: that people have a basic right to health-care as a necessary condition of a proper human life. Like education, political and legal processes and institutions, public order, communication, transport and money supply, health-care came to be seen as one of the fundamental social facilities necessary for people to exercise their other rights as autonomous human beings. People are not in a position to exercise personal liberty and to be self-determining if they are poverty-stricken, or deprived of basic education, or do not live within a context of law and order. In the same way, basic health-care is a condition of the exercise of autonomy.
Which of the followings is not an issue for every health system to tackle?
选项 A、What proportion of the community’s total resources should be spent on health-care.
B、What diseases and disabilities and which forms of treatment are to be given priority.
C、Which kinds of professions are to be given special consideration.
D、Which forms of treatment are the most cost-effective.
答案C
解析 细节题。根据第一段可知A选项“在卫生保健方面投入的资源应占社会全部资源的多大比例”，B“什么样的疾病和残疾以及什么形式的治疗应该享有优先权”，D“什么形式的治疗是最节省成本的”都有提及，只有C“哪种职业需要特殊关照”并没有提及，属于每一个卫生系统需要做出的决定，所以C选项为答案。
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