| 引用本文：丁辉侠, 张绍飞.从分割到融合：建国以来我国城乡基本医疗保险制度的变迁过程[J].中国卫生政策研究,2020,13(4):1-9 |
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| 从分割到融合：建国以来我国城乡基本医疗保险制度的变迁过程 |
| 投稿时间：2020-02-18 修订日期：2020-04-07 PDF全文浏览 HTML全文浏览 |
| 丁辉侠, 张绍飞 |
| 郑州大学政治与公共管理学院 河南郑州 450001 |
| 摘要:历史制度主义注重从长时期的历史脉络中，分析制度变迁的功能与动力机制。以历史制度主义为分析工具，本文把建国以来我国城乡基本医疗保险制度变迁分为城乡分割形成、城乡持续分割、城乡融合探索和城乡融合四个时期，发现我国城乡基本医疗保险制度从分割到融合的变迁过程亦体现为不同的经济社会条件下国家对人民医疗保障需求的有效回应。在不同时期，价值理念、行为主体和外部环境共同作用于制度变迁的方向和演化方式，从而推动城乡基本医疗保险制度不断打破分割，逐步走向融合。同时，在城乡基本医疗保险制度变迁的不同过程，都呈现出路径依赖、诱致性和强制性相结合的渐进性演化路径。但由于路径依赖等因素的影响，城乡基本医疗保险制度的全面融合任重而道远，在后续变迁过程中，需在统一筹资机制和完善支付制度的同时，还要保障城乡基本医疗保险制度的可持续性发展。 |
| 关键词:城乡基本医疗保险制度 制度变迁 历史制度主义 |
| 基金项目:国家社科基金（15BZZ054）；河南省青年教师骨干项目（2016GGJS-011） |
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| From segmentation to integration, the transformation process of China's urban and rural basic medical insurance system since the founding of the People's Republic of China |
| DING Hui-xia, ZHANG Shao-fei |
| School of Politics and Public Administration, Zhengzhou University, Zhengzhou Henan 450001, China |
| Abstract:Historical institutionalism focuses on analyzing the function and dynamic mechanism of institutional change from the historical context of a long period. Based on historical institutionalism as a tool for analyzing the changes from the founding of the People's Republic of China, this paper segmented the changes of China's urban and rural basic medical insurance system into four periods, namely the formation of urban and rural division, continuous division between urban and rural areas, exploration of urban and rural integration, and comprehensive integration of urban and rural areas.It was found that the transformation process of China's urban and rural basic medical insurance from division to integration is also embodied in the socio-economic conditions of different countries' effective response to people's healthcare needs. In different periods, the value concept, behavior subject and external environment jointly acted on the direction and evolution mode of the institutional change, thus promoting the urban and rural basic medical insurance system to break down the division and gradually move towards the integrated development path. At the same time, in different processes of within the urban and rural basic medical insurance system evolution, there was gradual evolution path that combined path dependence, inducement and mandatory combination along the system changes. However, due to the influence of path dependence and other factors, the comprehensive integration of urban and rural basic medical insurance system still needs to be further hustled for. In the process of subsequent changes, it is necessary to unify the financing system and improve the payment system while ensuring the sustainability of the basic medical insurance system in urban and rural areas. |
| Key words:Urban and rural basic medical insurance system Institutional change Historical institutionalism |
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