中国医疗卫生改革何处去——“甩包袱”式市场化改革的资源集聚效应与改进

Resource Allocation Effects and Improvements of Quasi-marketization Reform in China's Health and Medical Industry

本文归纳了中国医疗卫生服务领域市场化改革的基本特征——"甩包袱"式的市场化,并分析了此条件下医疗卫生资源在城乡之间、预防和治疗、低价药品和高价药品之间的分布状况。结论认为,"甩包袱"式的市场化条件下,医疗卫生资源会越来越向城市聚集、向疾病治疗聚集、向高价药品聚集,相反农村地区会缺医少药、预防体系薄弱、低价药品匮乏。接着,本文分析了医疗卫生服务的基本性质和公众对其改革的期望目标,指出"甩包袱式"的市场化改革只能解决"寡"的问题,而不能解决"均"的问题。本文建议继续市场化改革,但政府必须鼓励医疗服务竞争、打击垄断、维护好市场秩序,并承担起公共卫生和最低层次基本医疗服务的责任。

This paper believes it＇s a kind of quasi-marketization reform in China＇s health and medical industry since 1979, and its main feature is government didn＇t undertake its responsibility in the areas that market rule can＇t run. Through an agglomeration model, this paper finds that the health and medial resources would allocate more on the big cities, where have high density population, high purchasing power and low transaction costs; on the diseases treatment not precaution, and high price medical products and services. Then, this paper analyzed the nature of the health and medical service, common service, which means everyone, whoever is poor or rich, in rural or city, young or old, all should has the right to enjoy the minimum health and medial services. The conclusion is, government should shoulder its responsibilities of public health and minimum medical treatment, and anti-monopoly.