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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。
This paper argues that the study of governance and regulation is the weak link in the current medical and health research in China and needs special attention. The article starts from the difficult problem of how to manage and regulate the dual-track manufacturing of basic health and new medicine. By using regulatory perspective, this paper analyzes the problems of insufficient investment, low coverage of medical insurance, unreasonable price of medicine and medical machinery, institutional obstacles of public hospital and health administration Defective departmental supervision and other five medical and health problems, put forward the abandonment of governance and regulation not only led to all the existing problems more serious, but also made the modified behavior meaningless or negative effects. Finally, the author discusses the general reasons for the failure of regulation in China and proposes that establishing a regulatory agency for public health services that is independent of the administrative body may be a normative choice to promote fairness in health care in China and achieve universal primary health care.