日本医疗救助制度及对中国的启示

Japan’s Medical Assistance System and Its Enlightenment to China

通过梳理与分析日本医疗救助制度发展历程及经验,我们发现,在制度理念上,日本医疗救助具有发展型社会救助特征,重视受助者人力资本恢复和能力提升,强调疾病预防与保健等"上游干预"措施,最大限度地促进其自立自强;在制度设计上,日本医疗保障体系内嵌多道健康保障防线,减轻了医疗救助压力;在制度实践上,日本医疗救助广泛动员社会各方力量,且重视发挥商业保险对公共医疗体系的减压作用。日本医疗救助对中国的主要启示是,医疗救助制度建设要坚持立法先行,实现由生存型救助向发展型救助转变,公共医疗资源要向贫困弱势群体倾斜,救助实践中要激发社会主体活力,实现医疗救助的多元参与。

Through analysis of the development process and experience of Japan’s medical assistance system,it is found that in terms of institution concept,Japan’s medical assistance has the characteristic of the developmental social assistance,attaches importance to the recovery and promotion of recipients’human capital and capability,and also emphasizes the upstream interventions such as disease prevention and health care to promote their self-reliance to the greatest extent;In terms of institution design,multiple defense lines of health security are embedded in Japan’s medical security system,which to relieve the pressure on the medical assistance;In the practice of system,it mobilizes all social forces and pays attention to the decompression effect of commercial insurance on public health system.The main enlightenment of Japan’s medical assistance to China is that the construction of medical assistance system should adhere to legislation first and realize the transformation from survival-oriented assistance to development-oriented assistance,the public medical resources should focus on low-income groups,and the practice of medical assistance should stimulate the vitality of social subjects to realize multiple participation of medical assistance.