如何塑造更有效的卫生福利支出模式?——新加坡案例及启示

How to shape effective health welfare mode:The Singapore case and enlightenment

新加坡是生产主义福利国家的典型代表,始终保持着东亚国家和地区中最低限度的卫生支出,却也依然保有亮眼的卫生绩效。本研究将揭示其如何塑造更有效的卫生福利支出模式。具体而言,新加坡通过筹资侧的个人责任来激发成本意识和提高医疗服务效率,同时,通过供给侧的政府监管来纠正医疗领域的市场失灵,保证为全体居民提供良好且可负担的医疗服务。尽管在人口老龄化等挑战下,政府在卫生福利模式中加入了更多普遍主义的要素,并提供强大的医疗安全网,但其依然只提供最低限度的卫生福利支出,也依然强调个人和家庭对健康的责任。新加坡政府对卫生支出始终保持审慎态度,但通过积极干预和制度设计,政府实际上发挥了比单纯的卫生福利支出更复杂、有效的作用。

As a typical example of productive welfare capitalism,Singapore maintains the lowest health expenditure among East Asian countries and regions with impressive health performance.This study aims to discover how such effective health welfare mode can be shaped.Specifically,Singapore uses individual responsibility on the financing side to stimulate cost-consciousness,and improve the efficiency of healthcare services,meanwhile,corrects market failures in healthcare with government regulation on the supply side to ensure good and affordable health care for all residents.Although the government has provided more health benefit and a strong health care safety net in the face of aging population,it still maintains only a minimum expenditure on health benefits and keeps emphasizing individual responsibility for health.Singapore government has always been cautious about health expenditure,but it actually plays a more effective role than simply spending on health benefits through active intervention and institutional design.