(1) Interpersonal justice: It requires that medical practitioners interact with patients on an equal footing, and treat patients who are very different in the same way, i.e., treat them equally.
(2) Justice in resource allocation: It requires that the allocation and utilization of healthcare resources be optimized based on the basic principles of fairness, priority, and balance of efficiency, and that the allocation include macro- and micro-allocation.
①Macro-allocation: the solution is to determine the health care input, accounting for a reasonable proportion of the total national expenditure, as well as the total investment in preventive medicine, clinical medicine, scientific research, technology development, as well as basic medical care and special medical care and other levels of the reasonable proportion of the distribution of the problem.
② micro-allocation: is the distribution of hospitals and physicians for specific patients in the clinical diagnosis and treatment. China is currently mainly refers to hospital beds, surgical opportunities and the distribution of valuable and scarce medical resources.
Make a fundamental change in the allocation of medical resources. Operational level can start from the following two aspects:
1. Establishment of medical insurance physician system, improve the efficiency of the allocation of existing medical resources
The current medical insurance payment fixed qualification in the medical institutions rather than the individual doctor system, on the one hand, similar to the role of the establishment system, so that the doctor is difficult to separate from the public health care institutions to operate independently, and on the other hand, also strengthens the monopoly position of the public hospitals. The establishment of the physician health insurance system, that is, the unit of health insurance designated from the medical institutions to the individual physician, so that doctors do not have to rely on public medical institutions to obtain health insurance qualification, the doctor from the dependence on the medical institutions, with the doctor from the unit of people to the social change, to help the doctor towards free practice.
At the same time, the medical insurance physician system to a large extent dismantles the ability of public hospitals to use their monopoly status to hold patients hostage to the medical insurance and even the government. As mentioned earlier, for public hospitals with monopoly status, the health insurance does not have the ability to cancel the qualification of health insurance to regulate its diagnosis and treatment and charging behavior, and even the ability to impose fines is also very limited. However, under the medical insurance physician system, the medical insurance can completely cancel the medical insurance payment qualification of individual doctors whose diagnosis and charging behaviors are in violation of the law. In this way, neither affects the accessibility of medical services to patients, but also strengthens the ability of health insurance to discipline doctors, but also improves the self-restraint of the physician community and the importance of personal reputation.