Li Ling, Fu Hongqiao
National School of Development, Peking University, Beijing, China.
Int J Health Plann Manage. 2017 Jul;32(3):240-253. doi: 10.1002/hpm.2424. Epub 2017 Jun 14.
This paper discusses the progress and prospects of China's complex health care reform beginning in 2009. The Chinese government's undertaking of systemic reform has achieved laudable achievements, including the expansion of social health insurance, the reform of public hospitals, and the strengthening of primary care. An innovative policy tool in China, policy experimentation under hierarchy, played an important role in facilitating these achievements. However, China still faces gaps and challenges in creating a single payer system, restructuring the public hospitals, and establishing an integrated delivery system. Recently, China issued the 13th 5-year plan for medical reform, setting forth the goals, policy priorities, and strategies for health reform in the following 5 years. Moreover, the Chinese government announced the "Healthy China 2030" blueprint in October 2016, which has the goals of providing universal health security for all citizens by 2030. By examining these policy priorities against the existing gaps and challenges, we conclude that China's health care reform is heading in the right direction. To effectively implement these policies, we recommend that China should take advantage of policy experimentation to mobilize bottom-up initiatives and encourage innovations.
本文探讨了始于2009年的中国复杂医疗改革的进展与前景。中国政府开展的系统性改革取得了值得称赞的成就,包括扩大社会医疗保险、改革公立医院以及加强基层医疗服务。中国的一种创新政策工具——分级政策试验,在推动这些成就方面发挥了重要作用。然而,中国在建立单一支付体系、重组公立医院以及建立一体化医疗服务体系方面仍面临差距和挑战。最近,中国发布了医改第十三个五年规划,提出了未来五年医疗改革的目标、政策重点和战略。此外,中国政府于2016年10月公布了“健康中国2030”蓝图,目标是到2030年为全体公民提供全民健康保障。通过对照现有差距和挑战审视这些政策重点,我们得出结论,中国的医疗改革正朝着正确的方向发展。为有效实施这些政策,我们建议中国应利用政策试验来调动自下而上的积极性并鼓励创新。