中国卫生筹资转型的主要逻辑--一个探索性的分析框架

The main logics of China s health financing transition:An exploratory analytical framework

以卫生筹资规模扩大和公共筹资责任强化为核心的卫生筹资转型被视为实现全民健康覆盖的必要条件。对比全球趋势,中国的卫生筹资转型呈现鲜明特征。通过融合多学科理论,本文提出一套多层次、综合性的分析框架,包括以纵向“嵌入性”与横向“互补性”为基础的系统结构功能,以“维护和促进健康价值及其衍生价值”与“防范和化解健康风险及其关联风险”为导向的双向权衡机制,以卫生健康伦理原则与政府实际治理模式为核心的预算决策机制,以现代医学的三重属性为主线的长期发展路径。据此探讨了中国卫生筹资转型的总体逻辑和深层原因。

The health financing transition,which is centered on the expansion of health financing scale and the strengthening of public financing responsibility,is regarded as the necessary condition for achieving universal health coverage.Compared with the global trend,China s health financing transition presents obvious characteristics.By integrating multidisciplinary theories,this paper puts forward a multi-level and comprehensive analysis framework,including the system structure and function based on vertical“embeddedness”and horizontal“complementarity”,the two-way trade-off mechanism guided by“maintaining and promoting health value and its derived value”and“preventing and resolving health risks and their associated risks”,the budget decision-making mechanism centering on the principles of health ethics and the actual governance mode of the government,and the long-term development path with the triple attributes of modern medicine.Accordingly,this paper explores the overall logic and deep reasons for China s health financing transition.