转型中的中俄医疗保险制度比较分析

Comparison of the medical insurance systems in China and Russia in a transitional period

20世纪80年代后,中俄两国以不同形式开启社会转型,医疗保障体系发生巨大变化。本文对中国和俄罗斯在社会转型阶段所构建的医疗保险体系进行分析,从保险设计中的国家—市场关系、筹资缴费形式、服务购买等相关领域比较中俄两国面对转型期不断增长的医疗需求所做的不同回应。之后,从埃斯平·安德森所提出的去商品化和福利社会分层两个角度对中俄两国的社会保险制度进行了讨论。文章认为,中俄两国在转型当中所构建的医疗保险体制具有对原体制的继承性,市场在转型当中处于一种为国家所用的状态。医疗问题属于世界性难题,而"转型"无疑给中俄两国医疗体制带来了更大的复杂性。

China and Russia have both experienced huge social changes since the last century, and their medi- cal security systems have changed dramatically. This paper focuses on the medical insurance systems that China and Russia constructed in social transitional periods and compares their reactions facing the growing health care needs. The main areas of comparison are sate-market relation in insurance design, forms of funding and payment, and serv- ice purchasing. Then, the conception of de-commodification and welfare social stratification raised by Espin-Anderson are used in a value discussion. This paper argues that the new systems of both China and Russia have inherited a lot from the original systems, and markets are appurtenances of states. Medical problems are worldwide, and social transition will undoubtedly add more complexity to China and her neighbor Russia.