荷兰卫生体系管理竞争改革的经验及对我国的启示

What can China learn from the regulated competition reform in the Dutch healthcare system

近20年的荷兰卫生体系改革过程中,政府管制和市场机制在协调卫生服务的公平与效率中发挥了重要作用。本文重点分析了荷兰卫生体系引入管理竞争改革的经验,并认为从政治和技术角度来看,管理竞争是一种非常复杂的模式,必须满足一系列前提条件。结合我国医改实际情况,提出荷兰卫生体系改革对我国的几点启示:首先,必须坚持长期一致的改革战略;第二,实质性的改革无需在体系内进行疾风骤雨式的变革;第三,中国卫生体系改革要引入市场机制需要许多前提条件。

The Dutch healthcare system has been implementing the reform of regulated competition for decades.Such a reform achieved a balance between equity and efficiency.In this paper,experiences from the Dutch healthcare reform of regulated competition are described and analyzed according to the Chinese context.The Chinese government needs to fulfill a list of pre-conditions to make competition in the healthcare sector successful.And the reform of regulated competition may be a politically and technically complicated process.There are four important lessons that China can learn from the Dutch reform： first,strategy of the reform must be consistent in a long term;second,fundamental reform is not necessarily taken in the form of dramatic change in the system;and last,to introduce market mechanism into China＇s health reform,some preconditions are required.