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权利、约定和尊严

Rights, Agreements and Dignity

--《基本医疗卫生与健康促进法》的核心价值初探

-A Preliminary Study on the Core Values of the Law of the People’s Republic of China on the Promotion of Basic Medical and Health Care

胡晓翔

Hu Xiaoxiang

摘  要  权利、约定和尊严，是《基本医疗卫生与健康促进法》最核心的价值取向，其首要的立法主旨即在于具化《宪法》有关公民基本权利规定。公民基本权利，首要的是人权。生存权是最重要的人权，生存权不仅仅指生命权本身，还包括维持生命健康的各种必须的条件，因此，生存权必然导出生命健康权，也就必然要求政府确保公民的“基本医疗卫生服务保障权”。在此共识性基点上的社会“约定”，即立法予以明确国家的实现义务。《基本医疗卫生与健康促进法》建基于人权的最重要组成部分健康权，定位其于积极人权属性，据以配置国家和各级政府的实现职责，以及保障机制和措施，辅之以监督与制裁规制。在立法设计上以足够的篇幅充分阐明了政府必须承担起保障责任，我国政府有足够的经济实力在公民的基本医疗保障上有更大的作为。由此推进健康中国战略，奠定小康社会的本底。整部法律定位清晰、理念高蹈，结构谨严、层次分明。

Abstract: Rights, agreements and dignity are the core values of the Law of the People’s Republic of China on the Promotion of Basic Medical and Health Care (“the Law”), and its primary legislative purpose is to embody the provisions of the Constitution on citizens’ basic rights. The basic rights of citizens are, above all, human rights. The right to subsistence is the most important human right. It not only refers to the right to life itself, but also includes various necessary conditions to maintain life and health. Therefore, the right to subsistence inevitably leads to the right to life and health, and inevitably requires the government to ensure citizens’ “basic medical and health service guarantee right”. The social “agreement” on this consensus basis, that is, legislation is used to clarify the state’s realization obligation. The Law is based on the right to health, the most important component of human rights, and defines it as a positive human right attribute. It aims to stipulate the realization responsibilities of the state and all levels of government, as well as safeguard mechanisms and measures, and supervision and sanction regulations. In the legislative design, it fully expounds that the government must assume the responsibility of protection. Our government has sufficient economic strength to make more efforts in the basic medical protection of citizens in a bid to push forward the strategy of a healthy China and lay the foundation for a well-off society. The whole law features a clear orientation, lofty ideas, a cautious structure and clear levels.

关键词 权利  约定 尊严  健康权  国家实现义务

Key words: Rights, agreements, dignity, right to health, state’s realization obligation

1 概述

1 Overview

权利、约定和尊严，是《基本医疗卫生与健康促进法》最核心的价值取向，是理解这部“基本法”的锁钥。

Rights, agreements and dignity are the core values of the Law and the key to understanding the Law.

作为基本医疗卫生与健康促进领域的母法，立法的主旨即在于具化《宪法》有关公民基本权利规定。公民基本权利，首要的是人权。生存权是最重要的人权，生存权不仅仅指生命权本身，还包括维持生命健康的各种必须的条件，因此，生存权必然导出生命健康权，也就必然要求政府确保公民的“基本医疗卫生服务保障权”。在此共识性基点上的社会“约定”，即立法予以明确国家的实现义务，在立法设计上以足够的篇幅充分阐明了政府必须承担起保障责任，我国政府有足够的经济实力在公民的基本医疗保障上有更大的作为。由此推进健康中国战略，奠定小康社会的本底。这个路径，习总书记有明确指示。2019年4月15日下午，习总书记到石柱土家族自治县中益乡华溪村贫困户谭登周家时的讲话指出:“基本医保、大病保险、医疗救助是防止老百姓因病返贫的重要保障。这个兜底作用很关键。”所谓“基本医保、大病保险、医疗救助”，一言以蔽之，就是确保群众的基本医疗卫生服务的可及，和符合与社会发展相适应的水准。可见，基本医疗卫生服务，在习总书记的健康促进思想体系里，成为了解决“两不愁 三保障”突出问题的“兜底”措施，具有主纲的地位，显然不是市场里的买卖的民事行为，其实，是作为积极人权的国家和政府实现义务的胜负手来布局的。因此，习总书记要求，“加快完善低保、医保、医疗救助等相关扶持和保障措施，用制度体系保障贫困群众真脱贫、稳脱贫。”才能使得全民免于病伤就治经济负担的恐惧，从而不因伤病而减损尊严！要而言之，即：凭权利和约定赢得尊严！这也是《基本医疗卫生与健康促进法》核心价值最浓缩的概括。