多层次医疗保障的体系整合与制度衔接——以健康权实现为中心  

System Integration and Coordination of the Multi-level Healthcare Security:Centering on the Realization of the Right to Health

作　　者：赵亚宁 ZHAO Ya-ning

机构地区：[1]武汉大学法学院

出　　处：《保险研究》2025年第3期19-30,共12页Insurance Studies

基　　金：国家社科基金后期资助项目“保险法上道德风险控制机制研究”(20FFXB030);2024年武汉大学“弘毅博士后”计划。

摘　　要：“健全多层次医疗保障体系,促进多层次医疗保障有序衔接”是我国践行“以人民健康为中心”理念的重要顶层设计和政策要求之一,将相关政策予以法律化有助于更好地发挥法治对于健康领域中国式现代化的引领和保障作用。然而,关于多层次医疗保障的法治化整合与衔接问题,目前的立法与学理回应均有不足。针对多层次医疗保障当前实践中的碎片化和制度衔接不畅难题,应将健康权保障作为法治化整合与衔接的根本依循。健康权是多层次医疗保障制度的权利基础,其在我国具有实证规范渊源,其健康保障之主旨契合我国多层次医疗保障的体系功能,并且有助于深化政策与法律在健康治理方面的协同,更有效地实现人民健康。以健康权实现为中心,我国多层次医疗保障的体系整合与制度衔接在整体框架上应当以健康权内含的健康正义理念为价值引领,以健康权从保障生存权到保障发展权的层次递进构建涵盖托底层、基础主体层和补充促进层的医疗保障体系,以积极健康权实现和整体性治理为基本逻辑厘清国家和社会在各层次医疗保障中的义务和责任;在实施路径上应当从功能协调、组织协同、数据共享、救济整合等方面对多层次医疗保障的衔接协同机制作出多维度规范设计。“Improving the multi-level healthcare security system and promoting the orderly coordination of the multi-level healthcare security”is one of the important top-level designs and policy requirements for China to practice the‘people's health-centric concept'.The legalization of the relevant policies will help to better bring into play the role of the rule of law in leading and safeguarding the modernization of the health sector with the Chinese characteristics.However,current legislative and doctrinal responses to the issue of integration and coordination of the multi-level healthcare security system under the rule of law are inadequate.In response to the problems of system fragmentation and poor coordination in current practices of the multi-level healthcare security,the protection of the right to health should be taken as the fundamental basis under the rule of law.The right to health is the right foundation of the multi-level healthcare security system,which has an empirical normative origin in China.Its main purpose of health protection fits the function of China's multi-level healthcare security,helps to deepen the synergy between policy and law in health governance,and realize people's health more effectively.Centering on the realization of the right to health,the system integration and coordination of China's multi-level healthcare security should be based on the value of health justice embedded in the right to health,and on the hierarchical progression of the right to health from the guarantee of the right to subsistence to the guarantee of the right to development in the construction of a healthcare security system covering the bottom layer,the basic principal layer and the supplementary promotional layer,and on the realization of the positive right to health and the holistic governance of the basic logic of the rationale to clarify the obligations and responsibilities of the State and society in the various levels of healthcare security.A multi-dimensional normative design should be made for the coo

关 键 词：多层次医疗保障 健康权 国家责任 政策法律化 整体性治理 

分 类 号：D922.284[政治法律—经济法学]