政府与农村基本医疗保健保障制度选择

The Government and Options for Alternative Medical and Health Systems in Rural Areas

本文根据作者掌握的档案文献和田野调查资料 ,描述分析了中华人民共和国成立以来农村基本医疗保健制度的变迁及经济体制转型期间乡村人口在获得健康服务方面遭遇的困难 ,并在此基础上提出了可供选择的政策干预手段。文章表明 ,基本医疗服务广泛的可及性和政府对群体预防活动的强有力支持曾经是中国农村健康事业取得伟大成就的重要原因。目前乡村人口在医药供给并不短缺的情况下 ,却出现了看病吃药既不便宜又不方便的问题 ,可以说是部分地丢失这一传统的结果。它表明 ,预防医疗保健是一个不能简单听凭市场调节的领域。这些问题的解决取决于对这一产业的有效治理 ,即对基本医疗保健服务领域进行有效的监管和操作。

Based on archival material and field investigations, the author traces the evolution of medical and health systems since the founding of the People's Republic of China. He describes the difficulties experienced by rural people in terms of access to medical services during the period of economic transformation, and puts forward alternative policy options. In the author's opinion, with strong support from the government, China's rural health care system was very successful in the past with easy access to medical care for the broad masses. However, although there is now an abundant supply of medicines in hospitals and drugstores, rural people find it difficult and expensive to get medical services. The fine old traditions have been partially lost. Medical and health services should not be left entirely to the control and regulation by the market. The government must exercise effective supervision and governance of basic medical and health services in rural areas.