John Rawls's contractarian theory is based on an argument regarding what reasonable people would decide if they were asked to come together to derive a fair set of criteria for distributing societal goods, operating under the hypothetical assumption that they could by chance be in any position in a society in which such criteria would be applied-including the least socially or economically advan-taged (Rawls 1971). Rawls reasoned that under these circumstances, the following criteria would be endorsed,in order of importance:(1) maximize everyone's rights to liberties compatible with a similar system of liberty for everyone ;(2 assure fair equality of opportunity for people with similar abilities and skills; and (3) make sure that those who are the worst off benefit. The first two criteria have a strong egalitarian orientation, and the third emphasizes that if any group counts more than another, it is those who are worst off, financially or otherwise. This perspective focuses on those least able to buy care or be cured.
The social justice perspective on substantive equity, based in the need criterion, is concerned with subgroup variations in health. The primary goals of the U.S. Public Health Service Year 2000 Ob-jectives for the Nation include increasing the span of health life for all Americans, as well as reducing health disparities between and among groups ( NCHS 1995). Indicators of mortality, morbidity,and years of potential life lost or quality years of life gained are illustrative of the types of indicators that could be used to trace trends and subgroup variations reflective of the extent to which needs are actually met.
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約翰Rawls的contractarian理論根據關於什麼合理的人民的一個論據決定他們是否請求一起來獲得公平的套標準為分佈社會物品，經營在假定假定外他們在這樣標準應用包括最少將社會上或經濟上有條件的社會可能偶然是在所有位置(Rawls 1971)。 在這些情況下Rawls原因，以下標準將簽名，按照重要性的順序：(1)最大化大家的權利到自由與自由兼容一個相似的系統為大家; (2保證公平的機會均等為人與相似的能力和技能; 并且(3)確信，是最壞的好處的那些人。 前二個標準有一個強的平等主義的取向，并且三強調若有小組比別的計數更多，它是，財政或者是最壞的那些人。 這透視集中於那些最不能買關心或被治療。
對實質的產權的社會正義透視，根據在需要標準，與在健康上的小群變化有關。 美國公共衛生服務年-2000宗旨的主要目標為國家包括增加健康生活間距為所有美國人，並且減少健康差距在和在小組(NCHS之中之間1995)。 潛在的生活失去的死亡率、病態和幾年顯示或生活被得到的質量年是說明的可能被用於追蹤趨向和小群變異反射性程度需要實際上適應顯示的種類。