摘要
中国在医疗保障改革发展过程中,逐步形成了地方化特征明显的医保决策体制。这一体制具有一定的历史合理性,适应了医保发展初期制度扩面和有效管理的需要。但是这一体制导致的医保制度、政策的地方差异,不仅引发了很多问题,而且难以适应医保发展进入新阶段的要求。改革的方向是提高医保决策重心,规范各级政府医保决策权力,建立统一的医保国家制度。当前正在推进的医疗保障待遇清单制度,是对医保国家制度的一个初步设计,值得关注和加强研究。
Over the course of China’s health care reform and development,a policymaking system that is highly localized has been established.This system is reasonable in certain contexts,and conducive to the expansion and effective management of the health insurance in its early stage.However,the regional differences in health care schemes and policies cause by localized policymaking not only result in many problems,but also make it difficult for the healthcare system to adapt to new situations.The paper proposes to divert policymaking authority to higher government levels,regulate policymaking authority of all levels of governments,and establish a universal national health care system.The Health Care Benefit List System currently being implemented is a preliminary form of the national health care system,which deserves more attention and further research.
作者
单大圣
Shan Dasheng(Development Research Centre of the State Council,Beijing 100010,China)
出处
《社会保障评论》
CSSCI
2022年第6期85-99,共15页
Chinese Social Security Review
关键词
医疗保障
决策
地方化
health care
policymaking
localization
作者简介
单大圣,国务院发展研究中心研究员。主要研究方向:医疗保障体制改革。
