药品集中采购中市场与政府作用的机理探讨

Discussion on the Mechanism of the Role of Market and Government in the Centralized Drug Procurement

以药品集中采购和使用为突破口的进一步深化医药卫生体制改革为背景,从市场和政府失灵的角度论述使市场决定医药资源配置和更好发挥政府作用的必要性;从药品价格、医疗服务价格、医务人员薪酬回归市场合理水平三个方面解析市场决定医药资源的机理,从"放""管""服"三个方面解析更好发挥政府作用的机理;并提出进一步破除过度医疗、打击骗保、加大财政投入、完善医保筹资制度、改革医保支付方式等措施,以确保市场决定医疗资源配置和更好发挥政府作用的可持续性。

The centralized drug procurement and use organized is a key form of the medical resource allocation,and the combination of market mechanism and the government role is a crucial guarantee for realizing the optimal allocation of medical resources.The mechanism of medical resources decided by the market is analyzed from drug price,medical service price and medical staff salaries.It explores to better play the role of government from different dimensions.It proposes to further stop excess healthcare,crack down the fraud,increase the fiscal input,perfect medical insurance financing system,reform the medical insurance payment,so as to ensure the market dominant the medical resource allocation and better play the accessibility of the government role.