2008年,医疗卫生领域最为重大的事情是新医改方案的征求意见稿于10月14日在发展和改革委员会的网站上公布,并在一个月内向社会各界征求意见。该征求意见稿对于医疗保障体系建设的部分,阐述得最为明确,即建立以城镇职工医保、城镇居民医保、农村新型合作医疗以及城乡医疗救助为核心的基本医疗保障体系。在现实中,这一基本医疗保障体系的轨道已经铺好。在基层,无论是新医改方案还是有关的试点,均显示城乡社区卫生服务机构将走向一种行政化的体系,即由各地卫生行政部门全面恢复对这些机构人、财、物的行政管理。但是,对于公立医院,新医改方案征求意见稿重申了“管办分开”的改革指导原则,并且把“建立和完善法人治理结构”明确为改革的具体措施。
<<In 2008,the draft of the official proposal for a new round of health care reforms was released for public examination in mid-October. The blueprint for constructing a basic health care security system is clear. Actually,the institutional framework for this system has been in place,be comprising of three public health care insurance schemes targeting urban employees,urban residents,and rural residents,as well as Medicaid schemes in urban and rural areas. In comparison,the direction of reforming health care delivery system is still unclear. One approach is to restore a planned economy of community health care services,and the other is to push forward the corporatization of public hospitals. How these two approaches would be compatible with each other in the future will become a big problem.
<<Keywords: | Corporatization of Public HospitalsPublic Health Care InsurancePrivatizationthe Planned Economy of Health Care Services |