多维分权约束下地方政府的应急反应机制探讨--突发公共卫生事件的视角

Emergency Response Mechanism of Local Government under Multi-dimensional Decentralized Constraints--The Perspective from Public Health Emergencies

在新冠肺炎疫情突然暴发和迅速蔓延的严峻形势下,地方政府作为应急处置的责任主体,及时启动应急反应机制对于弱化疫情的负面冲击极为关键。本文着眼于应对突发公共卫生事件的地方政府应急反应机制的重构视角,将多维分权约束纳入政府部门的政治体制架构,依次分析了不同级次政府、政府内部各部门以及政府与医疗卫生部门在面对突发公共卫生事件时的博弈关系和协调机制,以及地方政府应急反应机制的财政基础与财政分权的应急管理效率。研究发现:应急分级管理和财政分权制度下,地方政府存在公共卫生投入不足、防控公共卫生风险不积极、夸大公共卫生事件危害程度等道德风险问题;在横向政府内部分权约束下,地方政府面临财政资金效率低下、公共卫生信息反馈机制不健全,以及各部门缺乏良好的行动和政策协调等现实困境。进一步地,基于湖北省和武汉市应对新冠肺炎疫情的典型现实,尝试提出应急分级管理体制和财政分权体制兼容的应急反应机制优化方案,希冀能为地方政府面临突发公共卫生事件时提供政策启示。

Under the severe situation of the sudden outbreak and rapid spread of the COVID-19 epidemic,the local government,as the main body of emergency treatment,starts the emergency response mechanism in time to weaken the negative impact of the epidemic.This paper focuses on the reconstruction of emergency response mechanism of local government in response to public health emergencies,integrates multi-dimensional decentralization constraints into the political institutional structure of government departments,and then analyzes the game relationship and coordination mechanism between different levels of government,internal departments of government and health departments in the face of public health emergencies,as well as the fiscal basis of local emergency response mechanism and the emergency management efficiency of fiscal decentralization.It is found that under the system of hierarchical emergency management and fiscal decentralization,the local government has the problems of insufficient public health investment,inactive prevention and control of public health risks,exaggerating the harmful degree of public health events,etc.Under the constraints of decentralization within the horizontal government,the local government faces the difficulties like inefficient fiscal funds,imperfect feedback mechanism of public health information,and lack of policy coordination among various departments.Further,based on the practice of Hubei Province and Wuhan City to deal with the COVID-19,this paper puts forward an optimization scheme of emergency response mechanism compatible with the system of emergency grading management and fiscal decentralization,hoping to provide policy implications for local governments in the face of public health emergencies.