ABSTRACT

South Africa’s (SA) National Health Insurance Policy (NHIP) underpins the establishment of a unified health system in the country based on the principles of social solidarity, progressive universalism, equity and health as a public good and a social investment, underscoring the values of justice, fairness and equity. The right to health contains both freedoms and entitlements with the latter providing for equality of opportunity to allow for everyone to enjoy the highest attainable level of health which is analogous to an ethically acceptable minimum standard of quality (EAMSQ). Inequalities in health coupled with striking increases in the cost of healthcare have inevitably stimulated debate on the role of justice and its requirements of particular societies. The level of access is dependent on distributive justice principles. This takes into consideration available social resources and a fair approach to the process of decision-making, necessitating another critical process; that of priority setting, which ranks services according to their importance and hence determines the distribution such that both winners and losers are created. Priority setting is assisted by the right to health principle. Health equity is central to the understanding of social justice with priority being given to the worst off. The aim of the paper is to develop a set of ethical elements of the EAMSQ, which aligns with the Constitution’s commitment to the right to healthcare.

摘要

南非（SA）的国家健康保险政策（NHIP）支持在该国建立基于社会团结，渐进式普遍主义，作为公共物品和社会投资的公平和健康原则的统一医疗体系，从而强调了南非的价值。正义，公平与公正。健康权既包含自由，也包含应享权利，后者规定了机会均等，使每个人都享有可达到的最高健康水平，这类似于道德上可接受的最低质量标准（EAMSQ）。健康方面的不平等以及医疗费用的惊人增加不可避免地引起了人们对正义的作用及其对特定社会的要求的争论。获取权限的级别取决于分配正义原则。这考虑到了可用的社会资源和对决策过程的公正态度，因此需要另一个关键过程；优先级设置，即根据服务的重要性对服务进行排名，从而确定服务的分布，从而创造赢家和输家。健康权原则有助于确定优先次序。卫生公平是理解社会正义的关键，最贫困者应优先考虑。本文的目的是发展EAMSQ的一系列道德要素，这与宪法对医疗保健权的承诺相一致。它根据服务的重要性对服务进行排名，从而确定服务的分布，从而创造赢家和输家。健康权原则有助于确定优先次序。卫生公平是理解社会正义的关键，最贫困者应优先考虑。本文的目的是发展EAMSQ的一系列道德要素，这与宪法对医疗保健权的承诺相一致。它根据服务的重要性对服务进行排名，从而确定服务的分布，从而创造赢家和输家。健康权原则有助于确定优先次序。卫生公平是理解社会正义的关键，最贫困者应优先考虑。本文的目的是发展EAMSQ的一系列道德要素，这与宪法对医疗保健权的承诺相一致。