中国新医改反思

从新中国成立初到现在,中国无论是经济建设还是社会面貌都发生了翻天覆地的变化,这其中也包括医疗卫生体制革新所引起的变化。随着国家的富强和社会的进步,民生不足愈来愈被政府和社会所关注,医疗卫生事业作为社会民生工程中重要的内容之一,它不仅关系到老百姓的生命健康,也是国家发展的基础和社会稳定的基础。对于加快中国新一轮医疗卫生体制革新,彻底解决好老百姓“看病难、看病贵"不足,成为构建社会主义和谐社会的重中之重。本文立足于中国医疗卫生体制革新的历史背景,主要浅析浅析中国新医改存在的政府责任、医疗卫生机构的公益性及公平性不足,从而反思中国新医改的发展方向。首先对中国新医改的历史背景进行简单的回顾,总结出中国医疗卫生体制革新的脉络。笔者对其医改历史分为三个大的阶段来进行浅析浅析:第一阶段,新中国成立初到革新开放前(1949-1978年)。在计划经济条件下,这一时期医疗卫生事业取得过显著成就,有很多值得赞扬的经验,但其中存在的不足也不少。总的归纳起来,主要表现在政府主导下的医疗卫生事业,使全民基本上能享有到相对平均的医疗卫生怎么写作,而在医疗卫生怎么写作体系发展和医疗保障水平上依然存在很大差距、医疗资源的浪费现象等成为当时医疗卫生事业发展中存在的主要不足;第二阶段,革新开放后到中国新医改前(1979-2009年)。在市场经济条件下,中国医疗卫生事业逐步走上了商业化、市场化的轨道。这一时期中国医疗卫生体制革新政策大体经历了“前期造势-多方集资-市场化革新-思路定型”四个过程。虽然这一时期的医疗卫生怎么写作体系、医疗保障水平以及医疗资源配置等取得了进展,但是暴露的不足更为严重,老百姓“看病难、看病贵”不足成为全社会关注的焦点,全民健康保障受到严重挑战,医疗卫生领域不公平性不足日益突出,从总体上来讲,医疗卫生体制革新是不成功的;第三阶段,中国新医改到至今(2009年-至今)。对于第二阶段中国医疗卫生体制革新不成功的结论,社会各界都在关注中国新一轮医疗卫生体制革新的进展以及对其评述,笔者总结和归纳了这次新医改所具有的新特点。虽然这次新医改构建了比较完善的框架体系,在一定程度上缓和了前两个阶段的严重不足,但不管任何制度、政策都会存在缺陷和不足,接下来就是笔者要探讨中国新医改的主要不足。中国新医改存在的不足有很许多,笔者主要从政府责任、医疗卫生机构的公益性以及中国新医改的公平性展开重点研究,分别从不同层面来浅析浅析不足的实质,为了探索未来中国新医改的发展模式,最后,笔者对中国新医改提出五点建设性的意见,一是坚持把医学原则融入其医改的始终,为中国新医改定下理论基石;二是坚持正确的价值取向,体现中国新医改的方向;三是坚持合理性原则来处理公共产品与公共怎么写作的关系,体现政府对医疗卫生事业的公共管理能力和医疗卫生怎么写作的可及性;四是加快基本医疗保障和怎么写作的公益性建设,提倡免费医疗,实现未来中国“人人享有基本医疗怎么写作”;五是坚持最优化原则来构建中国新医改的模式,为保证中国新医改取得实质性的突破,走一条有中国特色的社会主义新医改道路。

【Abstract】wWw.shuoshilunwen.com Now the new China was founded early in China, whether economic construction or social outlook of which an earth-shaking changes he of taken place, which also include the reform healthy system, which caused changes. With the country’s prosperity and social progress, people’s livelihood is more and more attentive by our government and society, the health care industry as a livelihood project is one of the important contents, it is not only related to people’s lives and health, is also the basis for national development and social stability.To speed up the new round of health system reform, Completely solve the common people "see a doctor of your" problems, which Becomes the top priority of building a sociali harmonious society of sociali. This health system based on Chinese medical history of the background, the main analysis of China’s new medical reform the existing government responsibility, public welfare medical institutions, and equity issues, which reflect China’s new development direction of medical reform. Firstly, China’s new health care reform is carried out on the historical background of a simple review, summing up China’s reform of health system context. The author of its history of medical reform in three major phases analyses: The first phase of early establishment of New China to reform and opening up (1949-1978 years). In the planned economy, medical and health services during this period had made remarkable achievements, there are many commendable experiences, but a lot of problems. Induction up the total, mainly manifested in the health care under our government-led business, so basically all the people enjoy the relative erage medical and healthy services, and medical and healthy services the development of the health-care system and the level of the medical protection exists still, health care resources waste of medical and health services such as the development was the main problems; The second stage of reform and opening up to new medical reform in China before (1979-2009 years). In a market-oriented economy, the Chinese medical and healthy services gradually became a commercial, market-oriented track. The poling of China’s health system during this period which has undergone a "pre-rally multi-financing-market-oriented reforms-Ideas shape the" four processes. Although this period of medical and healthy service system, the level of medical care protection and medical resource allocation, the progress made, but the problems of the exposure are more serious, People "see a doctor in your" question has become the focus of attention of the community, Serious challenges to national health security, medical and health inequity is increasingly prominent, generally speaking, health-care reform is unsuccesul; The third stage, China’s new medical reform to date (2009-present). For the second phase of China’s health system reform, the unsuccesul conclusion of the community are concerned about China’s new round of health system reform, progress and their comments, the author sums up the medical reform by the new features with the new. Although the new medical reform framework for building is a relatively perfect system, to a certain extent, ease the first two stages of the serious problem, but regardless of any system, policies are flawed and inadequate, the next is that the author approaches the key problem the new Chinese medical.China’s new medical reform there are many problems, I will focus on our government responsibility, health-care institutions and focuse on equity issues, From different dimensions to analyse the substance of the problem, In order to explore new medical reform model of the future development of China’s, Finally, the future of China’s new five-point health-care reforms are put forward constructive suggestions. First, we persist in integrating the principle of the medicine ethics with medical reforms throughout, to establish the cornerstone of new medical reforms in china. Second, we persist in the correct value orientation, embody the direction of new medicine reforms in china. Third, we persist in the rational principle to deal with the relations of the public products and public services. Fourth, we persist in speeding up the public welfare construction, including the basic medical safeguard and service. Advocating the free medical service, to achieve that all Chinese will enjoy the basic medical service. Fifth, we persist in constructing the pattern of new medical reform of china by the optimized principle,to safeguard the substantive break through to obtain, we must he a path with the new medical reform of Chinese characteristic sociali’s road.

【关键词】 中国新医改;;公平;效率;公正;
【Key words】 China’ s new medical reform;ethics;fair;efficiency;justice;

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