医疗公平与中央政府的再分配能力

on justice of medical and health resources and the redistribution capabilities of the central government

本文关注和讨论医疗卫生资源在全社会分配的公平性与中央政府再分配能力之间的关系.我国前几轮的医改基本不成功的症结在于医疗卫生资源分配的不公平,而公平分配医疗卫生资源的责任应当由中央政府承担.通过对国外关于分配公平的主要理论和医疗卫生体制的典型模式的考察,并结合中国具体情况,本文主张保障全民平等享有基本医疗卫生服务是中央政府的责任.中央政府能否履行好这一责任,取决于其再分配能力的强弱,而经过本文的实证考察,我国中央政府当前的再分配能力不足以履行好这一职责.要增强中央政府的再分配能力,需要建立一个以民主为基础、以公共需求为取向、以平等为追求、以法律为保障的完善的公共财政制度.

This article concems and discusses the relationship between the distributive justice of medical and health resources in the whole society and theredistribution capabilities of the central government. The failur ecrux of the former rounds of Chinese medical system reforms lies in the inequitable distribution of medical and health resources．And the central government should be responsible for equitable distribution of medical and health resources．Through studying theories of distributive justice and typical modes of medical care systems in foreign countries ，and consideration of Chinese characteristics，the author claims that the central government should be responsible for the universal coverage of basic medical and health services．That whether the central government Can fulfill this responsibility depends on the strength of its redistribution ability．But the current resource redistri-bution capacity of the Chinese central government is inadequate to fulfill this responsibility． To enhance the redistribution capacity of the central government ，it is necessary to establish a sound public financial system，which is based on democracy，public demand-oriented tendency，pursuit of equality and protec-tion from law．