美英两国医改新进展及对中国医改的启示

The new development of health reform in US and UK and its implications for China

最近,美英两国医改都有了一些新的进展,在各自国内产生了极大影响和震动。美国医改的主攻方向是以扩大医保覆盖面、实现全民医保为目标,英国医改主要是在医疗费用风险承担上进行改革,在医疗服务体系中实行进一步的管办分离。尽管两国医改的侧重点不同,但医改的基本方向一致,即在筹资和医疗卫生体制的宏观管理上,增强政府的组织领导功能,而政府放手和退出医疗卫生的实际生产和微观管理过程。英美两国医改关于政府职能的双重调整,对于中国新医改具有重要的启示意义。

The new initiatives of health reform undertaken recently in the US and the UK have caused great impact and shock in their countries.The main goal of the US health reform is to expand health insurance coverage and realize universal coverage,while the UK goal is to reform its risk sharing mechanism in health care finance,and further separate government role from daily operation.Although their respective emphasis is different,the general direction in both countries is same.That is to increase government role in health care financing and in macro-management of health system,but reduce and withdraw government role from health care provision and micro-management.This dual adjustment in government role has its implications for China＇s new health reform.