“全民免费医疗”的认识误区与理论解析  

Misconceptions and Theoretical Analysis of"Universal Free Healthcare"

作　　者：苏泽瑞 Su Zerui(School of Labor and Human Resources,Renmin University of China,Beijing 100872,China)

机构地区：[1]中国人民大学劳动人事学院

出　　处：《社会保障评论》2023年第6期89-106,共18页Chinese Social Security Review

基　　金：国家社科基金重大项目“中国社会保障体系建设与扎实推进共同富裕研究”(21STA002)。

摘　　要：“全民免费医疗”是各界高度关注且争论已久的重要政策议题,但因对这一概念的理解有别、视角不同,相关争论存在诸多认识误区,进而影响公众的正确认知和政策层面的合理解读,不利于达成促进我国医疗保障制度发展的政策合意。基于权利义务的视角,“全民免费医疗”实质上是指政府主要以一般税收筹资并通过财政预算分配来为国民提供无偿医疗服务的国民健康服务,它既非“免费午餐”,也非“福利陷阱”,亦非必然存在“低效浪费”,而与社会医疗保险制度一样均是化解疾病风险的社会化医疗保障制度安排,二者各有优劣且存在制度间的政策学习与相互扩散现象。中国现阶段应当坚持缴费型社会医疗保险为主体的医疗保障制度,但面向未来也不应排斥建立在税收筹资基础之上的“全民免费医疗”选项,需要根据中国式现代化和走向共同富裕的时代背景以及人民群众的愿望做出理性选择。"Universal free healthcare"is a pivotal policy topic that has garnered widespread attention and sustained debate.However,diverse interpretations and perspectives surrounding this concept have given rise to several misconceptions.These misconceptions,in turn,impede the public's accurate understanding and the reasoned interpretation of policy,hindering the establishment of a consensus for advancing the development of China's healthcare system.Viewed through the lens of rights and obligations,"universal free healthcare"fundamentally denotes a national health service funded by the government primarily through general tax revenue and fi scal budgets,aimed at providing all citizens with free health services.It is neither a"free lunch"nor a"welfare trap,"and it is not inherently ineffi cient and wasteful.Similar to social health insurance,it represents a socialized healthcare system designed to address the risk of illness,each with its own strengths and weaknesses.Additionally,there exists a potential for policy learning and mutual diffusion between the two systems.At the current stage,China should uphold the contributory social health insurance as the cornerstone of its healthcare system.Looking to the future,however,the option of"universal free healthcare"based on tax fi nancing should not be dismissed outright.Instead,a rational decision should be made in alignment with the context of the Chinese path to modernization and the pursuit of common prosperity,as well as in accordance with the desires of the people.

关 键 词：全民免费医疗 认识误区 理论解析 

分 类 号：R197.1[医药卫生—卫生事业管理]