深化医改政策中有关“政府主导”几个需要澄清的误区  

An Analysis of Misinterpretations Regarding Government Guidance in Healthcare Reform and Their Corrections

作　　者：曹永福[1,2] 

机构地区：[1]山东大学人文医学研究中心 [2]山东大学医学院医学伦理学研究所

出　　处：《山东大学学报（哲学社会科学版）》2013年第1期148-154,共7页Journal of Shandong University(Philosophy and Social Sciences)

基　　金：教育部人文社会科学研究基金项目"中国(大陆)医药卫生体制改革的价值取向研究"(项目编号09YJAZH050);山东大学自主创新基金重点项目"脱离人体的器官和组织的社会伦理法律问题研究"(项目编号IFW12114)的阶段性成果

摘　　要："政府主导"是深化医改政策的重要原则。然而,在对该原则的解读和实施中存在着"政府主导即政府包办、即公立医疗机构主导、即高度行政化、即要排斥市场机制"等误区,对此需要加以澄清。我国基本医疗保障体系由政府主导,但并非政府包办,而应由政府、用人单位和个人共同承担筹资责任;我国医疗服务市场存在的必然性以及"政府失灵"的存在,使政府包办一般医疗服务没有必要。"政府主导"也不是公立医疗机构主导,医疗服务体系完全可以通过市场机制运作,"公立医疗机构主导"不利于公平医疗服务市场的建立。深化医改要加强政府对医疗卫生事业改革与发展的主导作用,但绝不是要回归计划经济体制下的"高度行政化"。政府主导不是要排斥市场机制,在医改中发挥政府主导的同时,市场机制同样可以起到基础性作用。Government Leading is an importance principle in the reform policy of the healthcare system in China.However,there are some misinterpretations about it,such as the government leading is the government undertaking everything,public-hospital leading,being thoroughly administrationoriented,and rejecting the market mechanism.And these misinterpretations should be clarified.Government Leading in China's healthcare system means the government,individuals and the company shoulder the responsibility of raising funds rather than the government undertakes everything.The market of healthcare and the possibility of the government dysfunction make it unnecessary for the government to do everything in the healthcare system.Government Leading isn't public-hospital leading.The healthcare system can work effectively in itself under the market mechanism.Publichospital leading doesn't help to establish a fair healthcare market.The reform of the healthcare system is intended to strengthen the role of the government but doesn't mean going back to the working pattern in the planned economy.Government Leading isn't rejecting the market mechanism because the market mechanism can play a basic role when the government takes the lead.

关 键 词：深化医改 政府包办 公立医疗机构主导 高度行政化 排斥市场机制 

分 类 号：R197.1[医药卫生—卫生事业管理]