医疗体制改革的理论思考

近来有关中国医疗体制改革的讨论，逐渐涉及公共经济学、卫生经济学理论层面的一些基本理念和基础概念，解决中国医疗体制改革缺陷的不少主张，也因为对基本理论、概念的混淆和对医改问题的历史成因认识不清，而对医疗服务中政府与市场作用的边界，以及在公平与效率的关系上陷入形而上学的思维方式。因此，有必要从理论和历史的视角上正确理解医疗服务性质、合理定位医疗体制改革，避免出现将政府作用神化和市场作用神化两个极端，重新厘定政府与市场、公平与效率在医疗体制改革进程中的均衡。

Thinking of health system reform

Recently, discussions about Chinese health reform have expanded to some concepts of public economics and health economics. Some propositions to make up the limits of Chinese health reform has misunderstood the border of health service between government and market, and the relationship between equality and efficiency, due to conception confusion and unclearness of reform history. So, it is necessary with theoretic and historic perspective to correctly understand health service, reasonably locate health reform and to avoid the government- dominated and market- dominated extremities. The balance between government and market, equality and efficiency would be fixed again.