社会医疗改革:我国药品集中招标采购的公共政策分析

Analysis on the Policy of Centralized Bidding for Medicine Purchase of in China

药品集中招标采购作为我国从计划经济向市场经济转轨过程中对药品流通体制推出的一项重大改革,改变了过去几十年来业已形成的药品产、供、销等各方面的利益分配格局,关系到医疗卫生事业、医药经济发展和社会医疗保障管理体制的大局。目前,该项政策在实施过程中暴露出药品零售价格中医疗机构利润虚高不下,招标成本转嫁等种种缺陷。基于这样的背景,本文运用公共选择理论中特殊利益集团和政府失灵理论分析问题产生的成因,评价这项政府政策行为的实施效果,力求从建立合理的分配机制、调动和保护各方面积极性的角度,提出合理的改进建议。

Centralized bidding for medicine purchase is an important reformation in the medicine negotiation system while in the process of transformation from planned economy to market economy. The reformation has changed the interest distribution in manufactures, supply and sale of pharmaceuticals which had been formed in the past few decades, and it affects developments of health care, economy of pharmaceuticals and the system of social medical insurance. In the process of implementation, some defects are revealed, i.e. the price of medicine at hospitals keep too high for the reason of profit; hospitals pass bidding costs to the customer, etc. Based on the situation, the theory of special interest group, the government failure in the public choice theory and the principle of public policy were used toanalyze the policy of centralized bidding for medicine purchase. The author provides some reasonable and practicable suggestions for the policy to adjust the system and make active to all partners in the system.