“三明医改”评估：卫生治理框架的分析

Evaluation on Health Governance:A Case Study of Sanming City

卫生领域的公共资金作为稀缺资源,大规模投入必然会导致对新增资金及其控制权的争夺,触发医改过程中的政治。卫生治理并不是政府包办,其精髓在于让政府充当协调者,将社会、市场和个人整合起来,通过制度和政策安排形成合力,以真正实现"病有所医",实现满足美好生活健康需求的愿景。权力、责任和利益在政府、"医疗""医药""医保"和公众等各方利益主体之间的分配和相互间的钩嵌关系将最终决定卫生政策的效果。从治理视角下来分析政策效果,有助于后续有针对性校正、修改卫生政策和措施。本文运用上述理论框架对三明医改作实证分析。

As a scarce resource, public funds in the field of health will inevitably lead to the scramble for new capital and its control and trigger the politics in the process of health reform. Health governance is not arranged by the government. Its essence lies in letting the government act as a coordinator and integrate society and individuals to work together through institutional and policy arrangements so as to truly realize the vision of "treating patients who have illness" and meeting the health needs of a better life. The distribution and interdependence of power, responsibility and interests among various stakeholders such as the government, "YILIAO", "YIYAO", "YIBAO" and the public will ultimately determine the effect of health policies. Analysis of the results from the perspective of governance helps to follow-up targeted corrections and modify health management policies and measures. This paper uses the above theoretical framework to make empirical analysis of the health reform of Sanming City.