整体性治理视角下的新加坡医疗保险治理体系及对我国的启示

从治理视角看,新加坡医疗保险是以政府为整合者、利益相关方广泛并深度参与的整体性治理体系,实现方式是政府主导下的部门合作和政府引导下的社会协作。政府主导下的部门合作是指在明确的治理目标下,政府负责医保体系形塑、政策制定和监督管理,准政府部门中央公积金局负责医保经办管理。政府引导下的社会协作是指利益协商的三方机制(利益相关方平等参与医保共治)和医保运行的公私整合(私人部门参与医保经办)。当前,我国医保治理创新应以《关于深化医疗保障制度改革的意见》为指导,以明确政府职责、推进法人治理、培育多元主体、加强机制建设为重点,推动建立共建共治共享的医保治理格局。

The medical insurance governance system of Singapore from the perspective of holistic governance and its enlightenment to China

From the perspective of governance, Singapore''s medical insurance system is a holistic governance system in which the government is the integrator and the stakeholders are widely and deeply involved. In China, the only way to achieve this is to strengthen sector cooperation under the leadership of the government and enhance social cooperation under the guidance of the government. Under the leadership of the government, department cooperation means that the government is responsible for the shaping, policy making, and supervision of the medical insurance system, and the Central Provident Fund Board, as a quasi-government department, is responsible for medical insurance management. Social cooperation under the guidance of the government refers to the tripartite mechanism of interest discussion where the stakeholders equally participate in medical insurance management and the public-private integration of medical insurance operation where the private sector must be involved. At present, the innovation of China''s medical insurance management should be guided by the Opinions on Deepening the Reform of Medical Insurance System. Therefore, focus should be fixed on clarifying the government''s responsibilities, promoting corporate governance, cultivating multiple subjects and strengthening the establishment of functional mechanisms so as to enhance a setup of a medical insurance governance pattern which promotes co-construction, co-management and sharing.