试点引致政策创新机制研究——以医保和卫生政策为例

A Study on the Mechanism of Policy Innovation Led by thePilot Projects--Taking the Medical Insurance and Health Policy as Examples

政策试点是中国政府官员制定政策时经常使用的政策工具。本文围绕政策试点如何引致政策创新这一核心议题,以医保和卫生政策试点为例,采用扎根理论研究方法,分析试点引致政策创新的机制。研究发现,政策导向学习贯穿试点全程,其会带来政策参与者信念体系的变化,推动试点实施进程;政策导向学习具有渐进性特征,即发起试点的官员通常从探索性学习逐步转变为验证性学习,信念体系相应逐步调整,或在试点过程中努力取得政策某一方面的创新,并以此为基础进一步试点,最终实现整体政策创新。基于以上发现,论文提出渐进政策学习理论,以对试点引致政策创新的机制予以解释。

Policy piloting is a policy tool frequently used by Chinese government officials when formulating policies. Taking pilot programs of medical insurance and health policy as examples, this study employed a grounded theory approach to explore how policy-oriented learning could play a role in the implementation of pilot programs and policy innovation. The study found that policy-oriented learning brings about changes in the belief systems of policy participants and thus promotes the implementation of the pilot programs. Policy-oriented learning is gradual, that is, the officials who initiated the pilots usually gradually change from exploratory learning to confirmatory learning, and their belief systems are gradually adjusted accordingly;or they make efforts to bring innovations in some aspect of the policy, which serve as a basis for further pilots and eventually lead to complete policy innovation. Based on the above findings, this study proposes a progressive policy learning theory to explain the underlying mechanism of pilot programs and policy innovation.