从获得治疗的权利转向保持健康的义务

武夷山

Futures 杂志2014年9月号发表法国学者Laurent Gille和Thomas Houy的文章，The future of health caredemand in developed countries：From the “right to treatment”to the “duty to stay healthy”（发达国家保健需求之未来：从获得治疗的权利到保持健康的义务）。文章的主题思想就是标题的这句话，我认为是了不起的认识。作者意识到实现这样的转变有多么难，文章最后一句是，“权利的表达是非常迅速的且容易取得共识。然而，义务之表达估计将是一个漫长的、充满矛盾冲突的历程。”

文章的要点与摘要如下：

Highlights

(1)The article is based onthe reflections by a working group composed of health care experts drawn from awide range of backgrounds.

(2)This article identifiesthe main tipping points likely to have an impact on health care demand indeveloped countries.

(3)The article shows thathealth care demand might be motivated by the duty of each citizen to doeverything possible to stay healthy.

Abstract

The aim of this article is to identify themain tipping points likely to have an impact on health care demand in developedcountries. The article is based on several exchanges between health careexperts within the framework of a working group coordinated by the authors.This article argues that there is a possibility of change in the determinantsof health care demand in developed countries. Over the medium and long-term,health care demand might no longer be expressed mostly by patients assertingtheir right to treatment. Instead it will be motivated more by the duty of eachcitizen to do everything possible to stay healthy. This transition from a “right” to a “duty” is alogical extension of various movements already observed in the health caresector.