新医改、医疗费用风险保护与居民获得感:政策设计与机制竞争  

New Round of Health Reform,Health Financial Risk Protection and Residents' Sense of Gain:Policy Design and Mechanism Competition

作　　者：彭宅文[1] 岳经纶[1] 

机构地区：[1]中山大学中国公共管理研究中心/政治与公共事务管理学院

出　　处：《广东社会科学》2018年第4期182-192,256,共11页Social Sciences in Guangdong

基　　金：2016年度教育部人文社会科学重点研究基地重大项目"社会政策创新与共享发展"(项目号16JJD630011);2014年度教育部人文社会科学重点研究基地重大项目"公务员养老金制度比较研究"(项目号14JJD630004);2013年度国家社会科学基金重点项目"中国社会医疗保险制度整合的效果评价"(项目号13AGL011)的阶段性成果

摘　　要：新医改以来,"全民医保"的实现,药品定价行政管制的取消与"零差率"的推行,付费方式与补偿机制改革的深入,以及卫生投入的急剧增加,极大地改善了基本医疗服务的可及性。然而,各行政主管部门负责的局部性、中间性绩效目标的改善,并没有带来医疗费用风险保护状况的明显改善。居民获得感褪色与卫生政策绩效的提升成为关键政策议题。本文基于卫生政策待遇设计分析框架检讨了相关政策设计,并进一步分析了新医改以来部门局部、中间性改革绩效改善明显而全局、最终性绩效改善有限背后,两种卫生政策干预机制的竞争及其负面影响。Since the new round of health reform,the realization of "universal health coverage," the abolition of administrative control over drug pricing and the implementation of " zero difference rate," the deepening of the reform of payment method and compensation mechanism and the sharp increase of health investment have greatly improved the availability of basic medical services.However,the fulfillment of the partial and intermediate performance objectives of the administrative departments in charge did not lead to a significant improvement in the financial risk protection.The fading of residents' "sense of gain" and the improvement of health policy performance are key policy issues.Based on the analysis framework of health policy coverage design,this paper reviews the deficiencies of the relevant policy design,and further analyzes the contradictions between and the negative effects of the two health policy intervention mechanisms which affect the performance of administrative departments in charge during the new round of health reform.

关 键 词：卫生筹资 患者医疗费用负担 社会医疗保险待遇 医疗保障模式 

分 类 号：C91[经济管理]