重大突发公共卫生事件医疗费用多元分担研究

Studying on the Multiple Sharing of Medical Expenses in Major Public Health Emergencies

目的:突发公共卫生事件医疗费用的合理分担是政府、社会和个人要面对和解决的关键问题,因此在重大突发公共卫生事件下构建平战结合的费用分担机制尤为重要。方法:从社会学、经济学等视角研究疫情费用分担机理规律,构建多元多维供需双向的分担机制,符合社会公平、正义的要求,以及我国现行的医疗健康体系。结果:发现我国医疗费用分担机制在应对突发重大疫情时具有应急性、临时性,且现行制度设计与实践运行不一致、突发公共卫生事件应对资金不足等问题。我国突发公共卫生费用分担从建国前缺乏分担到建国初政府分担为主,并逐步发展到现行的多部门协同,政府、社会、市场多主体分担的特点。结论:为进一步完善我国费用分担机制,应以明确法律法规中医疗费用责任、建立重大突发公共卫生事件专项拨款与临时拨款机制等路径,促进医疗卫生事业高质量发展,为构建人类卫生健康共同体奠定基础。

Objective To establish a cost-sharing mechanism for major public health emergencies.Methods From the perspective of sociology and economics,the law of epidemic cost sharing mechanism was studied,and the multi-dimensional two-way supply and demand sharing mechanism was constructed,which should conform to the requirement of social fairness and justice,as well as Chinese current medical and health system.Results It was found that China′s medical cost sharing mechanism was temporary in response to major outbreaks,and had the problems of inconsistent design with practice,and insufficient funds to deal with public health emergencies.The sharing mode of public health emergency costs has changed from the lack of sharing before the founding of the People′s Republic of China to the main sharing by the government at the beginning of the founding of the People′s Republic of China,and has gradually developed to the characteristics of multi-department coordination and multi-subject sharing by the government,society and market.Conclusion In order to further improve the mechanism of cost sharing in China,it is suggested to clarify the responsibility of medical cost in laws and regulations,establish the special appropriation and temporary appropriation mechanism for major public health emergencies,which can promote the high-quality development of medical and health services,and lay a foundation for building a community of human health.