基本医疗卫生改革的政治伦理、市场逻辑与未来走向

The Research on the Political Ethics,Market Logics and Future in the Basic Healthcare Reform

基本医疗卫生改革是当前实现“2030健康中国”和新时代下践行人民健康优先战略的一项制度创新。然而,现实中改革仍面临医疗资源配置不均和医疗服务供给效率不高的双重困境。本质上,医疗服务具有公利性与私利性二元属性,进而延伸出立足于公利性属性,基本医疗卫生改革应当坚守“人人公平享有”的政治伦理,鉴于私利性属性改革需要维护医疗市场主体合法逐利的正当权利,政府公利性创造与市场私利驱动是辩证性的哲学思考。我国医改未来应以公民健康与福祉共享为价值依归,始终坚持政府严守底线、市场有序竞争、社会和谐稳定的发展主线。

Basic healthcare reform is an important institutional arrangement for realizing "2030 Healthy China" and implementing the strategy of giving priority to people’s health under the new era. However, in reality, the reform still faces the dual dilemma of uneven allocation of medical resources and low efficiency of medical service supply. In essence, medical services have dual attributes of public interest and private interest. Based on the public interest attribute, the basic medical and health reform should adhere to the political ethics of "equitable access to healthcare". In view of the private interest attribute,reform needs safeguard the legitimate rights of medical market players to pursue profits legally. The creation of public interest by the government and the drive of private interest by the market are dialectical philosophical thinking. The future of China’s healthcare reform should be based on the sharing of citizens’ welfare of health and well-being, and always adhere to the main development line: the government’s strict adherence to the bottom line, orderly competition in the market, and a harmonious and stable society.