公共服务管理创新的三元分析框架——以“先看病,后付费”制度的地方试点为例

A Tripod- structured Theoretical Framework of Innovation in Public Service Management——Take Health Care Reform for Example

经典的政治学和公共管理学文献认为公共服务管理创新受制于财政水平。然而,当前正在中国开展的"先看病,后付费"制度的试点地区却并不限于财政水平较高的地区,部分财政资源不丰富的西部试点地区甚至走在了东部地区前面。对此本文提出基于财政、供方和需方的公共服务管理创新三元分析框架,指出财政、公共服务提供方、公共服务需求方三者共同决定着一个地区的公共服务管理创新,并选择山东、上海、重庆、青海展开实证研究。

Classic political science and public administration literature assumes that the innovation in public service management depends on the financial level. However, why are the pilot areas of the ＂treatment first＂ reforms not limited to those localities with higher financial levels,and part of the western regions where the financial resources are not abundant e- ven have better specific pilot measures than the eastern regions？ This article puts forward a tripod--structured theo- retical framework of innovation in public service management based on finance, supply--side and demand--side,sug- gesting that finance, public service .supply--side and demand--side jointly determine the innovation in public service management in one region. Empirically, this article compares the different reasons behind the ＂treatment first＂ reforms in Shandong, Shanghai, Chongqing, and Qinghai as well as the interaction mechanism among finance, supply--side and demand-- side.