中国医疗服务治理机制与政府干预分析

The Analysis About the Government Intervention and the Admimistration of Chinese Medical Service

医疗服务治理即对医疗服务提供方行为及质量的管理,涉及医疗服务的质量、效率、费用、安全等问题。医疗服务涉及人们的健康,具有极大的社会公益性,需要按照公共品的基本原则,规范其行为准则和公开其财务。当政府举办社会医疗保险计划时,保方因具有政府背景和政策决定权而具有了谈判优势,在医、患、保三方关系中居强势地位。保方通过限制参保患者就医地点和限制费用分担的方式制约医疗服务提供方,通过限制医疗服务项目和限制费用分担的方式制约参保患者,并避免医、患勾结造成自身损失。公民享有健康保障权利,公民需要也会创造各种渠道参与健康管理。

Medical service is administered for the problems such as the management that medical service offers behavior and quality, which is concerned with medical service, efficiency, cost and safety. Medical service is related to people＇s health and has great social public welfare, needs to normalize its behavior standard and reveal its finance according to the basic principle of public conduct. Beacuse it has the last saying about the policy and its government background, when government hold the ＂plan＂ social medical care be insured the insurer will have the advomtage in negotiation and be the leading role among the hospital, patient （ insured ） and insurer. Through setting a limit to the fixed hospital and the item of medical service even and the way to share the cost, the insurer restricts both the hospital and the insured, in order to avoid hospital colluding with patient, which will lead to their loss. What＇s more, citizens have health ensured right, needs and also will oreate varied ways to participate in health management.