我国香港地区的医疗保障体系及其启示

One Country, Two Welfare Systems:Healthcare in Hong Kong and Lessons

香港地区是中国"一国两制"背景下的两个特别行政区之一,它获准保留了自己的治权、政治体制、立法系统以及独立的医疗保障体系。得益于获得大量资助的公共收费体制,香港地区拥有了相对公平的医疗保障体系。相对地,中国内地的医疗保障体系却面临着诸多问题。对内地民众来说,迅速增长的医疗开销以及有限的医保覆盖面使他们逐渐难以负担起医疗服务。本文研究了香港地区的医疗保障政策与实践的历程并将其与内地进行比较,进而为内地医疗卫生制度改革提出两个主要建议:(1)提升质量和效率;(2)分离医院的管理与经营。最后,本文认为香港地区的医疗保障改革可以为内地今后的医保改革提供借鉴和参考。

Hong Kong is one of the two special administrative regions in China under the framework of ＂one country, two systems＂, which is permitted to retain its own governance, political structures, legislation, and an independent health care system. Hong Kong has a relatively equitable health care system as a result of a heavily subsidized public fee structure. In contrast, China's Mainland has integrated many features of market- oriented health care system. The rapidly rising health care cost and limited insurance coverage have made health care services increasingly unaffordable for the Chinese people. This paper examines and compares the development of the Hong Kong health care practices and policies with those of China's Mainland. This paper then suggests two major implications for China's Mainland＇ s health care system, namely, promotion of quality and efficiency, and separation between hospital management and hospital operation. Finally, this paper argues that Hong Kong＇ s own health care reform could set up a role model for China＇ s reform in the future.