摘要
不少决策者最初认为发生于2008年5月的汶川大地震会阻碍卫生改革进程,但事实上,针对地震的应急反应和重建为加速卫生体制改革提供了一个机遇。更重要的是,可以利用这个机会在四川和周边省份建立更好的卫生体系,以便全国其他地区借鉴。但是,新近颁布的重建规划关注重点是重建基础设施。文章认为,更好的做法是重建规划能同时有解决医疗卫生改革纲要中所提及的卫生行业目前面临的主要问题。要做到这一点,就需要政府在卫生、社会保障和其他领域采取有效的、协调一致的应对措施。灾后重建中,一个与卫生改革宗旨协调一致的卫生重建方案至少应包括三方面:实现人人享有医保、加强初级卫生服务和公共卫生服务、改革基本医疗卫生服务提供体系。
While most policymakers initially viewed the Wenchuan earthquake as an impediment to health reform, in fact, the post-earthquake reconstruction may provide an opportunity for accelerating the move to health system reform, and more importantly build back a better health system in Sichuan and surrounding provinces, which may also provide good lessons to the rest of the Country. The reconstruction strategy so far has focused primarily on physical infrastructure. The paper argues that it might be better that the reconstruction addresses key issues currently faced by the health sector that dovetail with the outlines of health care reform. As has been observed in other natural disasters, the poorest and most vulnerable--will need government-led support to recover. This would entail authorities to mount an effective and coordinated response in the areas of health care as well as social protection and others. A coordinated response in the post-earthquake reconstruction process might include at least three areas related to health sector reform （HSR）： Achieving universal coverage, strengthening of primary care andpublic health services, and reforming the basic health service delivery system. Anchoring the reconstruction strategy for health in HSR would encourage the reconstruction effort tO tackle the important systemic dimensions, such as policy coordination and implementation, regulations and enforcement, financing and governance, as opposed to an excessive emphasis on the physical re-building of health facilities. Citizens also can effectively assist in strengthening accountability and in facilitating the implementation of the reconstruction strategy and HSR. To be able to do so, however, citizens need information and channels for involvement in the monitoring, performance evaluation, and policy processes. Government could usefully involve citizens in outlining the exact scope and mode of delivery of public health and essential care. This consultation process could later be scaled up nation wide to strengthen public support for HSR.
出处
《中国卫生经济》
北大核心
2009年第1期10-15,共6页
Chinese Health Economics
关键词
卫生制度改革
灾后重建
卫生融资
医疗服务提供
卫生管理
公共卫生
health system reform
post-disaster reconstruction
heahhfinancing
healthcare delivery
governance forhealth
public health
