传统合作医疗制度重建艰难的原因分析——基于公共产品视角

传统农村合作医疗制度在人民公社时期,之所以能够解决中国广大农村的医疗卫生问题,是因为在"政社合一"体制下,政府发挥了组织、引导、管理、监督的作用,这在形式上契合了公共产品的理论.随着农村市场化改革的推行,政府职能没有随之改革和接续,合作医疗制度随之衰落.上世纪90年代政府试图重建合作医疗制度时,因过分强调农民主体作用,政府只起扶持作用,背离了农村医疗保障公共产品性质及其发展规律,从而导致了传统合作医疗制度重建屡屡受挫.

The Reasons of the Decline and Difficult Re-construction of the Traditional Cooperative Medical system——Based on the View of Public Goods

In the people's commune period,the traditional cooperative medical system was able to solve the health problem in the vast majority of rural areas of china.On the causes of it,under the system of "the integration of government and community",the government played an organized,guided,management and oversight role in the traditional cooperative medical system,which is agreement in the form of the theory of public goods.With the implementation of the market-oriented rural reform,government functions didn't reform and continue,so the cooperative medical system declined.In the 1990s,the government tried to re-construct the cooperative medical system,but because of too much emphasis on the role as the main peasants and the enabling role of the government,the cooperative medical deviated form the nature of public goods of the rural health protection and its development law.Because of this,the traditional cooperative medical system was repeatedly rebuffed.