农村医疗救助政策执行阻滞的利益分析

Interest Analysis on Impedance of the Execution of Rural Medical Assistance Policy

在农村医疗救助政策执行过程中,不同政策执行主体存在着不同的利益选择。从地方政府来看,维护地方利益和部门利益是其政策行为的重要价值依据。从民政部门来看,在保证救助经费够用的前提下,救助一定数量的农村贫困人口是其应对政策的基本立场。乡镇卫生院和县医院则认为,规避风险、利润最大化是其提供医疗救助服务的必要前提。从贫困人口来看,生存需要第一、健康需要第二是其根本出发点。这些不同利益选择所造成的张力大大削弱了政策执行的力度和效果,不利于农村贫困人口"看病难、看病贵"问题的有效解决。

In the process of carrying out the policy of rural medical assistance, different organizations executing the policy have different interest perspectives. For local govemments, the main basis for their actions in this aspect is to protect local and departmental interests. For civil departments, the fundamental stand is to assist certain number of poor people in rural areas under the precondition that enough expenditure is guaranteed. For hospitals and clinics in county capital cities and townships, the precondition for providing medical assistance is how to get rid of risks and optimize economic benefits. For people in need, their principle is survival first and health second. These different interest selections greatly weaken the strength and effect of the policy and have negative effect on effective solution of the prob- lems of ＂It is difficult and expensive to see a doctor＂ faced by rural oooulation in the field of medical treatment.