中国式现代化与医疗保障体系改革

Chinese-Style Modernization and the Reform of China's Healthcare System

中国式现代化的内涵和本质要求为医疗保障体系改革指明了方向。未来医疗保障应注重全民共享的普惠性,实现保健康“一个都不能少”;重视制度设计的公平性,有效促进共同富裕;提升基金管理的效率性,确保制度的安全规范和可持续运行;推动中医药传承创新发展,体现健康文化的民族性;推动构建人类卫生健康共同体,实现保障方案的世界性。然而,现行医疗保障体系存在与中国式现代化不适应的一系列问题,主要表现在:尚未实现“应保尽保”、济贫性和公平性不足、医保治理不协同、多层次医疗保障体系还未形成合力等。从中国式现代化的内在要求出发,医疗保障改革理念要实现从形式普惠到实质公平、从疾病治疗到健康促进、从费用控制到价值购买、由分散治理到协同治理的转变,并从优化制度设计、强化扶贫扶弱、倡导价值医疗和推进协同治理等4个方面全面深化改革。

The essence and core requirements of Chinese-style modernization provide guidance for reforming China's healthcare system.In the future,China's healthcare system should prioritize universality to ensure equitable access to healthcare for all.Attention should also be given to designing a fair system that promotes common prosperity.Enhancing the efficiency of fund management is crucial for the safe,appropriate,and sustainable operation of the system.Additionally,promoting the inheritance and innovative development of Chinese medicine,which reflects the national characteristics of healthcare culture,is essential.Strengthening the establishment of a global community of health for all can provide solutions to healthcare challenges worldwide.However,the current system faces several issues incongruent with Chinese-style modernization,including incomplete insurance coverage,insufficient poverty alleviation,fairness concerns,uncoordinated governance,and a lack of synergy among different levels of the healthcare system.Based on the inherent requirements of Chinese-style modernization,reform concepts should aim to transition from universal benefit to substantive fairness,from disease treatment to health promotion,from cost control to value-based healthcare,and from decentralized governance to coordinated governance.Comprehensive reforms are necessary to optimize institutional design,strengthen poverty alleviation and support for vulnerable groups,advocate value-based healthcare,and promote coordinated governance.