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引用本文:李珍, 王怡欢, 杨帆.论新时代医疗保险公法人治理体制的创新——基于多中心治理理论[J].中国卫生政策研究,2019,12(11):16-22
论新时代医疗保险公法人治理体制的创新——基于多中心治理理论
投稿时间:2019-10-17  修订日期:2019-11-20  PDF全文浏览  HTML全文浏览
李珍, 王怡欢, 杨帆
中国人民大学公共管理学院 健康保障研究中心 北京 100872
摘要:本文基于多中心治理理论检视发现,现行的医疗保险运行机制存在基本医疗保险基金所有权与管理权分离、医疗保险政策改革只能"做加法"不能"做减法",其他相关利益主体缺位、改革无法满足多方诉求,医保经办主体动力和能力不足等问题。这些问题不仅导致医疗保险制度的可持续性面临严峻挑战,而且与实现全民统一医疗保险制度的目标渐行渐远。因此,在新时代背景下,为了构建权责清晰、保障适度、可持续发展的医疗保险制度,本文提出创新医疗保险公法人治理体制,完善中国特色医疗保险治理体系,同时推进社会保险公法人治理机制的创新,促进政府、市场与社会之间的协同与配合,最终实现推进国家治理体系和治理能力现代化的伟大目标。
关键词:治理  多中心治理理论  医疗保险  公法人治理体制
基金项目:“2050年医疗保障战略目标与‘十四五’重点任务研究”基金(2019K20256);中国人民大学中央高校建设世界一流大学(学科)和特色发展引导专项资金(2020062)
Enlightment on the innovation of public corporation governance system of medical insurance in the new era: Based on the polycentric governance theory
LI Zhen, WANG Yi-huan, YANG Fan
School of Public Administration and Policy, Health Security Research Center Renmin University of China, Beijing 100872, China
Abstract:Based on the Polycentric Governance Theory, this study found that there are some issues in the current medical insurance operation mechanism, including the separation of the ownership and management of basic medical insurance fund, policy reform can only "add" but not "subtract", the absence of other relevant stakeholders, the inability of the reform to meet the demands of many parties, and the lack of proper motivation and ability of the agencies. This could not only lead to the challenges in the system sustainability, but also happened to be far away from reaching the goal of establishing a unified national medical insurance system. Therefore, in the context of the new era, in order to build a medical insurance system with clear rights and responsibilities, moderate security and sustainable development, it is highly suggested to innovate the public corporation governance system of medical insurance, improve the system with Chinese characteristics, promote the innovation of public corporation governance system of social insurance, promote the coordination and cooperation among the government bodies, market and society, and finally achieve the great goal of modernizing the national governance system and capacity building.
Key words:Governance  Polycentric governance theory  Medical insurance  Public corporation governance system
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