卫生立法的国际经验对我国的启示

本文通过分析典型国家卫生立法的现状和发展的共同点,结合我国政治、社会和经济环境,对我国《基本卫生法》立法提出政策建议。多数工业化国家都有一个相同的价值观,即政府确保公民不受地域和经济能力的限制享有卫生服务。各国卫生立法都经历了与政治发展同步的数次改革。几乎每一个以公共筹资体系为主的国家,都同时存在商业医疗保险和私人医疗服务,但医疗卫生服务体系很少以市场为主导。所有国家都在向建立整合的协同医疗服务体系方向努力,并已建立了与经济发展和国民收入相适应的、长期稳定的卫生筹资模式。作为卫生领域的根本法,《基本卫生法》应以更宏观的视角对卫生和健康问题的基本定位、基本价值和基本框架进行定位,突出"无论公民的性别、年龄、宗教、社会地位和经济状况,政府都有责任确保其获得基本医疗卫生服务和基本药物"的核心价值观。

International experiences and their implication for China's Essential Health Law

This paper aims to provide policy recommendations for health legislation in China considering specific political, social and economic local conditions, through reviewing and analysing the status and common characteristics of health legislation and historical development in respective countries, and summarizing experiences and lessons learnt.Most industrialized countries have the common political value that government has the final responsibility of securing universal access to essential healthcare regardless of geographic and economic restraints.Health legislation in each country experienced multiple reforms in concurrence with political evolution.All countries with public dominated health financing systems have private health insurance and private healthcare services, few of their service delivery systems are privately dominated.All countries have been towards the way to build an integrated health service delivery system.Appropriate and stable health financing system has been established to be in line with the economic development and national income level.As an overarching law for the health sector, the Essential Health Law should clearly define the fundamental orientation, the essential value and the basic framework of health issues with more maro-perspective and higher level point of views.It should highlights the core political value that, government should take the final responsibility of securing universal access to essential healthcare and medicines regardless of differences in gender, age, religion, social class and financial capacity.