摘要
Thanks to the reforms of the last two decades and more, China＇s health care resources have multiplied. Medical technologies, capacity, and proficiency have improved following the growth of human resources, increase in hardware input and greater opening up to the outside world. In the meantime, health care policies have undergone several reforms. Still, in the rating by WHO of public health systems of the 191 UN member nations in 2000, the overall stares of China＇s health care and sanitation was ranked 144^th. In terms of the equitable financing of national health care, China stood the last but three of all the 191 member nations, preceding only Brazil, Burma and Sierra Leone.
本文认为，治理与规管的研究是中国目前医疗卫生研究的薄弱环节，需要特别引起重视。文章从基本卫生与新医新药的双轨制造成治理和规管的难题入手，运用规管的视角，分析了投入不足、医疗保险低覆盖、药品和医疗机械价格不合理、公立医院的体制障碍和卫生行政部门监管不力等5个使医疗卫生陷入困境的论点，提出放弃治理与规管不但导致所有的现行问题更加严重，而且也使修正的行为变得没有意义或具负面效应。最后，作者讨论了中国规管失效的一般性原因，提出建立独立于行政机构的公立卫生服务规管机构可能是推进中国医疗卫生公平、实现全民初级卫生保健的一种规范性选择。
