政策反馈理论视域：中国医疗卫生政策钟摆式变迁及其逻辑

新中国成立以来，党和国家不断强化医疗卫生建设，70余年来医疗卫生政策演进呈钟摆式变迁的特征，即从公益导向的福利性医疗卫生政策摆向效率导向的市场化政策，再摆向公益为主兼顾效率的民生导向政策，在公益与效率间发生三次摆动。本文借助政策反馈理论分析医疗卫生政策钟摆式变迁的内在逻辑，发现政策变迁过程中原有政策通过资源效应、解释效应、演化效应和学习效应影响新政策的制定，使得新政策留有原政策的烙印，呈现出摆动式变迁而非剧烈或范式变迁。政策反馈理论为医疗卫生政策制定提供新视角，制定医疗卫生政策需注重原政策的历史影响力，以公共价值引领医疗医保医药政策，从多重政策反馈效应视角出发优化卫生政策的制定。

The perspective of policy feedback theory: The pendulum change of China's health policy and its logic analysis

Since the founding of the People''s Republic of China, the Party and the state have been constantly strengthening the construction of medical and health care. The evolution of medical and health policies over the past 70 years has been characterized by a pendulum change, that is, from the commonweal oriented welfare medical and health policy to the efficiency-oriented marketization, and then to the commonweal oriented people''s livelihood with both efficiency and public welfare as the priority. This paper analyzes the internal logic of pendulum change with the help of policy feedback theory, found in the process of the policy change original or old policy through resource effect, interpretive effect, the evolution effect and learning effect influence the formulation of the guidance, make the new policy with the imprint of the original policy, presents the pendulum change rather than violent or paradigm change. From the perspective of policy feedback theory, it is necessary to pay attention to the historical influence of policies in the formulation of medical and health policies, guide medical insurance and medical policies with public values, and improve the quality of health services with fine management, optimizing health policy development from the perspective of multiple policy feedback effects.