制度的逻辑、困境与出路——新医改背景下医疗政府管制模式重构

Way out of the dilemma of the medicare reforms——A model of reconstruction

建国以来,我国医疗管制及其制度体系一直处于不断改革和完善之中,经过了计划经济体制下行政性管制阶段、管制改革起步阶段、管制改革深入展开阶段、管制改革调整创新阶段。其发展路径是:直接→→行政管制放松管制强化管制。尽管遵循了不一样的制度逻辑,但都出现了各自的制度困境。因此应建立以健康为目标的"管制—竞争"模式,以提高医疗政府管制的有效性。

Ever since the founding of new China, the medicare institution and regulations have been in constant imp ovement, through the state planned economy, reform, and creativity models. In another word, the cevelopment process is called direct, loose and enforced administration. Dilemmas come into be- ing with the diversified systems. This paper concludes in a health-based or a regulation-competition mode of medicare reforms.