“健康中国”战略中基本卫生保健的治理创新

Governance Innovation in Basic Health Care in the “Healthy China” Strategy

强化基层医疗卫生机构的服务能力,是健康中国建设的战略目标之一。经过30多年的努力,中国建立了一个完整的基本卫生保健体系,但在高度行政化的医疗卫生健康供给侧,面向城乡社区居民的基本卫生保健提供者(即基层医疗卫生机构)处于庞大等级体系的最底端,始终处于积弱不振的境况。在健康中国建设进入新时代之际,基本卫生保健的治理亟待创新,其要旨是降低行政机制的主导性并调整行政机制运行的方式,同时引入市场机制和社群机制,并促使行政、市场和社群治理形成互补嵌入性的新制度格局。这一新制度格局的落地、生根,不仅与全球性基本卫生保健的改革大趋势相吻合,而且将有可能成为中国国家治理体系现代化在医疗卫生健康领域的重要体现。

Strengthening the service capacity of primary health care institutions is one of the strategic goals of the Healthy China Program.After more than thirty years of hard work,China has established a complete system of basic health care.However,on the highly administrative supply side of health care,basic health care providers(primary health care institutions)serving urban and rural residents are at the bottom of a huge hierarchy,leaving them permanently weakened.As the Healthy China Program enters the“new era,”the governance of basic health care urgently needs renewal.This implies reducing the dominance of administrative mechanisms and adjusting their operating mode while at the same time introducing market and community mechanisms to boost administrative,market and community governance and embed it in a new complementary institutional pattern.The establishment and consolidation of this new pattern will not only coincide with overall trends in the global reform of basic health care,but also offers the possibility of becoming an important expression of the modernization of China’s national governance system in the health care field.