激励结构与政府投入：从地方政府视角看合作医疗制度的可持续性  

Incentive Structure and Government Contribution:Rethinking Sustainability of the Rural New Cooperative Medical Scheme from the Perspective of Local Government

作　　者：刘军强[1,2,3] 

机构地区：[1]中山大学行政管理研究中心 [2]中山大学政治与公共事务管理学院 [3]中山大学社会保障与社会政策研究所

出　　处：《公共行政评论》2009年第6期126-155,共30页Journal of Public Administration

基　　金：教育部人文社会科学重点研究基地重大项目“中国社会政策的挑战与对策”(编号:08JJD840203);中山大学“211工程”三期“行政改革与政府治理”研究项目

摘　　要：新型农村合作医疗制度的高覆盖率是政府财政大量注入的结果,财政补助已占筹资总额的83%。这使得合作医疗制度的发展高度依赖政府,尤其是在政策执行和制度运行中起关键作用的地方政府。论文从新型农村合作医疗的筹资责任分担、制度建设和运行费用、政治收益等方面分析了地方政府面临的激励结构。研究发现目前的激励结构难以使地方政府持续地投入,这为该制度的长远发展带来了不确定性。The almost full coverage of the New Cooperative Medical Scheme (NCMS) has been achieved by governments' substantial investment.However,the sustainability of the NCMS is in serious doubt when historical lessons and incentive structure of NCMS policy implementation are considered.In this article,local governments are assumed as rational actors with self interests and the incentive structure for local governments in NCMS implementation is analyzed.The incentives of local government in financing,operating and getting political rewards from NCMS are examined.It is revealed that existing incentive structure is very weak in propelling local governments in financing and supporting NCMS since they have not particularly benefited from doing so.This paper argues that such an incentive structure brings in uncertainty to the long-term development of NCMS.

关 键 词：合作医疗 可持续性 地方政府 激励结构 

分 类 号：R197.1[医药卫生—卫生事业管理]