基于合理问责框架的卫生政策制定公平性研究——以重庆医改与医保目录修改为例

Analysis on the Perspective Equity of Health Policy-making Based on Accountability to Reasonableness Framework: Case Study of Reform in Chongqing and Health Insurance Directory Modification

中国改革开放前三十年里"效率优先于公平"的发展理念与模式严重破坏了卫生领域的公平,迫切需要转变中国卫生政策制定的治理模式,以求在符合公民利益基础上实现卫生资源分配公平。目前,中国卫生政策制定的治理模式仍停留在"作为结构的治理"及形式化的"作为过程的治理"阶段。文章进一步借助合理问责框架的公开、关联、修正、执行四条件来论证"作为过程的治理"比"作为结构的治理"更能体现程序公平,最后为转变中国卫生政策制定的治理模式提出三条路径。

In the first thirty years of China＇ s reform and opening up, the development concept and model of ＂efficiency pri- ority＂ seriously undermine the fairness of the health field, need to change the governance model of China＇ s health policy formulation to achieve a fair distribution of health resources in line with the interests of citizens. At present, the governance model of health policy in China is still stuck in the ＂governance as a structure＂and formalized ＂governance as a process＂. We further demonstrate that the ＂governance as a structure＂ is better than the ＂governance as a process＂ by mean of the public, the association, the a- mendment and the implementation. In the end, the article puts forward three ways to change the governance pattern of Chinese health policy.