话语与公共政策:公共决策的话语建构解释途径——以农村合作医疗决策过程(1955—1989)为例

Discourse and Public Policy:A Discursive Construction Approach to Public Policy-making——Taking the Cooperative Medical Policymaking in Rural China(1955—1989) as a Case

公共政策是话语建构下的产物,决策过程可以视为围绕特定议题的意义赋予、话语宣称与竞争的过程,竞争的'获胜者'将影响最终政策选择或变迁的方向。通过关注话语在'社会现象—社会问题—政策议题'转化过程中的作用,可以构建出一个理解决策过程的解释途径。以此来考察1955—1989年间中国农村合作医疗的国家决策过程,可以发现'集体化'话语、'革命'话语与'现代化'话语在不同时期内分别将与合作医疗相关的社会'现实'建构为不同的形态,从而奠定合作医疗决策或'无决策'的合理性基础。

Public policy is a product of discursive construction.Policy-making can be regarded as a process of meaning-giving,discourse-claims and competition around specific issue,and the 'winner' can affect the final directions of policy choice or change.By focusing on the role of discourse in the transformation process of 'social phenomenon-social problem-policy issue',we can build an interpretative model of policy-making process.Using this model to explain the national cooperative medical policy-making process from 1955 to 1989,we can find that in different periods,the 'collectivization' discourse,the 'revolution' discourse and the 'modernization' discourse respectively constructed the social 'realities' relating to the cooperative medical scheme into different forms,which laid the reasonable basis for the cooperative medical policy-making or nonpolicy-making.