加大公共卫生投入改革公共卫生筹资体制

从公共卫生投入体制和规模、公共卫生机构的收支状况着手研究中国的公共卫生投入及存在的主要问题，认为中国公共卫生投入主要存在投入体制不合理、投入不足、城乡或地区分配不合理等问题，并据此提出公共卫生投入的改革设想。     

Improving public health system performance through multiorganizational partnerships

Public health activities in the United States are delivered through multiple public and private organizations that vary widely in their resources, missions, and operations. Without strong coordination mechanisms, these delivery arrangements may perpetuate large gaps, inequities, and inefficiencies in public health activities. We examined evidence and uncertainties concerning the use of partnerships to improve the performance of the public health system, with a special focus on partnerships between public health agencies and health care organizations. We found that the types of partnerships likely to have the largest and most direct effects on population health are among the most difficult, and therefore least prevalent, forms of collaboration. High opportunity costs and weak and diffuse participation incentives hinder partnerships that focus on expanding effective prevention programs and policies. Targeted policy actions and leadership strategies are required to illuminate and enhance partnership incentives.     

Redistributive effects in public health care financing

This article focuses on the redistributive effects of different measures to finance public health insurance. We analyse the implications of different financing options for public health insurance on the redistribution of income from good to bad health risks and from high-income to low-income individuals. The financing options considered are either income-related (namely income taxes, payroll taxes, and indirect taxes), health-related (co-insurance, deductibles, and no-claim), or neither (flat fee). We show that governments who treat access to health care as a basic right for everyone should consider redistributive effects when reforming health care financing.

农村公共卫生服务项目效果、成本和筹资政策研究之三：公共卫生服务项目筹资政策分析

为了解决卫生筹资和服务系统存在的问题,在筹资政策方面,已有很多改革措施和政策建议。世界银行曾于1996年对我国提出了“一揽子”筹资改革建议,并预测了这些改革将对卫生服务系统产生的潜在影响。在建议中,全额资助主要公共卫生服务项目和为低收入人群提供基本卫生服务补助被认为是最重要的两条,它们将在提高居民的健康水平、促进公平性、提高效率和控制成本等方面发     

我国公共卫生筹资改革措施评价

我国公共卫生筹资改革有两个明显特点：一是政府经费补助相对减少，二是对公共卫生服务实行有偿服务，改变了公共卫生机构的筹资结构。在1980年实行筹资改革以前，公共卫生机构的一切支出全部由政府经费补偿；在实行改革之后的90年代中期，政府经费占机构总收入的比例下降到30％－50％，仅能补偿人员工资，有偿收入所占比例相应地增加到50％－70％，以市场为导向的公共卫生筹资虽能提高机构的经济活力与生产效率，但同时也暴露出一些问题。经济激励机制导致了不必要卫生服务的过度提供与必要卫生服务的提供不足。有偿服务减少了人们对具有正外部效应的预防保健服务的需求和利用，政府经费不足导致了公共产品的供给不足。以往的实践证明：政府在公共卫生筹资中的作用减弱可导致社会资源利用的低效率；实行有偿服务会抑制人群对这些服务的需求，增加疾病发生的危险性；以市场为导向的公共卫生筹资改革不能作为一项政策选择，一旦采用这类政策，就会造成许多不良后果。     

黑龙江省公共卫生机构筹资状况研究

公共卫生机构在提供公共卫生服务活动中发挥了重要作用,公共卫生机构的筹资状况对公共卫生服务工作的开展有着重要影响。通过对黑龙江省公共卫生机构筹资状况的研究,分析了财政补助对公共卫生机构的影响和黑龙江省公共卫生机构费用的构成状况,提出了发挥政府在公共卫生筹资中的主导作用;完善政府对公共卫生的投入机制,健全公共卫生服务经费保障机制等建议。