| 摘要: | The original ideal of medical training is to cultivate physicians who are devoted to saving lives based on humanistic concerns. As the world becomes more modernized and medical cost rises, equitable distribution of the increasingly scarce medical resources is becoming a more difficult issue for advanced countries. In the industrialized nations, democratic mechanism is often used when seeking resolution concerning public health care policy. Although the legislative process may take a long time, and the outcome can hardly please everyone, the character of public health care system in industrialized nations is often in accordance to the country’s political reality. For instance, in the US health care services rely heavily on market-driven HMOs, whereas Scandinavian countries develop their medical insurance policy based on their socialist inclination. All in all, it is easier for the governments in Europe and north America to reach reasonable agreements in finding effective strategies for medical resource distribution because of their solid democratic tradition; in the newly democratized Asian countries, however, solving the dilemma is usually much harder. Why is it so? First of all, in Asia’s authoritarian tradition, the government is expected to take comprehensive care of its people’s welfare, as opposed to the west where the government is only obliged to protect people’s basic rights, the extent of which is defined in the constitution through democratic discussion and negotiations. Therefore in the west allocation of medical resources is more transparent and socially predictable; but in most Asian countries, policy direction is largely dependent on charismatic leadership, so the decision making process is often obscure and arbitrary to the public. Using Taiwan as an example, although it is one of the first democracies in Asia, decision making in public health policy is mostly constrained to the elite. In other words, Taiwan’s public health policy is still |
