美国卫生体系面临的挑战及对中国的启示

本文系统分析了美国卫生体系面临的挑战及其原因。文章认为美国卫生体系目前存在诸多挑战:卫生支出大幅增加、医疗服务利用不足与过度并存、健康水平低于大多数发达国家、基层医疗机构全科医生数量明显不足等。而国家立法的失误、卫生管理系统不够完善等是造成美国卫生体系面临众多挑战的主要原因。吸取上述美国的历史教训,结合中国国情,提出以下启示:应保障人人享有卫生保健的基本权利;重视和发挥政府以及基层医疗机构的作用;加强全科医生队伍建设;改革支付方式,控制医疗费用的增长;加强立法,合理处理医疗事故和纠纷。

Challenges in the U.S. healthcare system and their implications for China

This article discusses challenges in the current U.S. healthcare system and their fundamental causes. Such challenges include increasing health expenditure, deficiency and excess in health service utilization, worse health outcomes than other developed countries, and insufficient GP numbers. We suggest that mistakes in early healthcare legislation and an imperfect health management system are the primary causes for these problems. Implications for China's current ongoing healthcare reform are outlined. We draw on the experience in the U.S. and other developed countries but keep China's unique features in mind. Factors that need to be considered in China are ensuring the right of healthcare for all, giving full play to the role of government and primary medical institutions, strengthening support for GPs, reforming payment modes, controlling the growth of health expenditure, strengthening legislation, and handling medical accidents and disputes reasonably.