摘要
在中国的医疗卫生体制改革中,卫生部门居于非常重要的位置。现有文献对于中国卫生部门的弱势、"保护主义"和部门利益的分析虽然有一定意义,但却未能对其官僚制基础、政治地位、现实处境和组织能力进行全面考察,作出更加接近事实的分析。论文通过对福建省卫生厅2005年以来领导的一项以控制医疗费用过快增长为主要内容的政策干预的研究发现,地方的卫生部门并非缺乏改革的意愿,亦非全然是改革的阻碍力量。问题的关键在于来自外界的政策压力、来自政府的政治支持、卫生部门自身的政策决心,以及发动、使用、配置现有行政资源和政策工具的能力。
The Chinese health bureaucracy plays a vital role in this country's healthcare reforms.However,plenty of criticism prevails in the literature on its weak bureaucratic power,protectionism over health facilities,and self interest,which has led to the conclusion that the Chinese health bureaucracy is inherently incapable of leading reforms.However,this article finds that similar conclusions are unfortunately based on inaccurate depictions of the health bureaucracy's political standing,situation,and capacities.By examining a healthcare reform led by Fujian Provincial Health Bureau that is committed to cost containment,this article argues that the local health bureaucracy does not truly lack the motivation for reform,nor is it a hindrance.The key to understanding this reform lies in three aspects,which are political support from the government,policy determination of the health bureaucracy itself,and appropriate alignment of policy instruments at its disposal.
出处
《公共行政评论》
2011年第2期97-115,180,共20页
Journal of Public Administration
关键词
组织力量
行动策略
医改
卫生部门
福建
医疗卫生政策
Bureaucratic Power,Strategy,Healthcare Reform,Health Bureaucracy,Fujian,Health Policy