中国社会福利的内卷化及发展--中国市场化转型中社会福利制度的变迁

Involution and Development of Social Welfare in China： Institutional Change of Social Welfare in the Market Transition

经济体制改革以来,特别是20世纪90年代全面向市场经济体制转轨以来,我国的经济获得快速持续增长,全社会对公共服务和社会福利的投入总量不断增加,但是广大民众特别是低收入人群的社会福利状况没有改善,本文称之为“社会福利的内卷化”.本文以医疗卫生服务为例,通过数据和案例分析,指出在公共服务、社会福利的责任结构中,政府责任后退,政府公共服务资源投向出现偏差,医疗服务商品化,社会财富分配严重不公,是社会福利内卷化的原因.2003年以来社会福利开始走出内卷化状态,走向发展,其重要原因是对发展的科学认识以及“以人为本”的经济社会政策的实施.文章还讨论了社会福利的发展模型得以实现的条件.

China has experienced a successive rapid economic growth after economic reform and especially after its shift toward market economy in 1990s. With the progress of economic development, the total input on public services and social welfare has increased continuously. However, social welfare condition of the nlajority of Chinese citizens and particularly of those low-income groups has not been improved, which the author defines as ＂involution of social welfare＂ in this paper. Based on health care service analysis, the author analyzes the main causes of the involution of social welfare in China, namely, government retreat, commodification of health care services and serious unfairness of wealth distribution in the responsibility structure of public services and social welfare. The situation of social welfare involution somehow has changed since 2003, when government has adopted a scientific approach of development and implemented a series of person- centered socio-economic policies. In the paper, the author also discusses the preconditions of the development model of social welfare