中国医疗保障制度创新研究
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摘要
上世纪60年代兴起的健康经济学对医疗保障进行了深入的理论研究,分析了医疗保障制度的效率性和公平性;主要西方国家建立了完善发达的社会保障制度,在医疗保障改革和发展上积累了大量经验教训。这些理论和实践上的丰硕成果为研究中国的医疗保障制度创新提供了有意义的参考和借鉴。
中国目前的医疗保障制度具有自身特点,可分为四个层次:城镇基本医疗保险、新型农村合作医疗、医疗救助、商业健康保险。从现状看,中国医疗保障的主要问题是由于历史原因和经济发展水平限制,保障水平低和覆盖面窄。同时,经过20余年的改革和发展,公立医疗机构过度商业化,医疗市场结构扭曲,卫生资源配置不合理,医疗服务供给效率低下,进一步恶化了医疗保障状况。
中国医疗保障制度不但直接受到医疗改革影响,还间接受到医学模式的影响——医学模式通过与医疗改革的互动对医疗保障制度产生重大影响。总的来看,现代社会的医学模式正在由重事后治疗转向重事前预防,由此引发了医疗领域的健康革命,我国的城镇基本医疗保险正在向基层向社区倾斜,社区卫生服务迅速发展。同时,医学模式的转变也大大提高了中医药在提高国民健康水平中的地位。
在上述的医学模式转变与卫生改革背景下,论文研究了中国医疗保障制度的四个层面。城镇基本医疗保险是医疗保障的主体,文章在既有的研究基础上重点分析了现代医学模式对其影响;医疗保障制度的创新研究重点放在商业健康保险(医疗保障制度的必要补充)、医疗救助(医疗保障制度的最后防线)和新型农村合作医疗(医疗保障制度的延伸)上。最后,在上述研究基础上,文章把医疗保障和卫生改革所涉及的主体全部纳入到医疗市场中,从第三方管理(TPA)的角度进行了博弈分析,研究了市场结构创新对医疗资源运用效率的增进机制。
文章创新之处主要表现:(1)分析了我国公立医疗机构过度商业化的特征,揭示了现行医疗保障体制的内在缺陷,对未来中国医疗保健市场进行了预测。(2)从医疗服务的公共服务产业角度出发,研究了中国医疗服务的市场结构完善,提出通过培育医疗市场的第三方管理者(TPA)推动市场结构创新,促使公共服务产业发展的改革思路。(3)分别从城市贫困人口、社区残疾人、遭遇突发事件三个角度对医疗救助问题进行深入剖析,并结合杭州西湖区的案例研究提出了政策建议。
The health economics from 1960's has maken a deep research into the medical care system, playing the emphasis on analyzing its efficiency and equity. At one time, the major western countries have developed diversified and sophisticated institutions of social security system, accumulating lots of experience on medical security system reform. So, China can draw lesson to enhance her medical care system innovation from the theatric and practical rich harvest mentioned above.
China's medical care system has its own characteristics and consists of four aspects: fundamental medical security in cities, new rural cooperative medical care system, medical assistance, commercial insurance on health care. Considering present situation, because of historical reasons and economy develop level, the main problems include low security standards and narrow coverage. At the same time, after more than 20 years' reformation and development, the new medical system problems come forth which include over commercialized, medical market structure distorted, medical recourses unjustly allocated, and medical service supply with low efficiency, all of which worser the situation of medical security.
Medical security is affected not only by Health system reformation directly, but also by the model of medical science indirectly. The interactions between medical reformation and the model of medical science influences medical security system greatly. General speaking, the model of medical science in modern society changes from emphasizing on medical treatment afterward to medical prevention beforehand, inducing health revolution. As a result, fundamental medical security in cities in China is attaching weight to community, health service in community is developing rapidly, and the status of Chinese traditional medicine is being improved greatly.
Under the background of heath system reformation and medical science model transition, this paper makes a research into the 4 aspects of medical security system in China. Fundamental medical security in cities is the main body of medical security system, this paper just points out the influence of medical science model transition upon it. This paper just pays emphasis on the following 3 aspects: new rural cooperative medical care system, which is the extend of medical security; medical assistance, which is the end line of defense of medical security; commercial insurance on health care, which is the necessary supplement of medical security. On the basis of the above investigation, this paper puts the interest parties involved in the medical security and health reformation into the medical market, makes a research with the game theory from the point of view of third party administration(TPA), which investigates the mechanism of enhancement medical market innovation upon medical resources utilization efficiency.
中国目前的医疗保障制度具有自身特点,可分为四个层次:城镇基本医疗保险、新型农村合作医疗、医疗救助、商业健康保险。从现状看,中国医疗保障的主要问题是由于历史原因和经济发展水平限制,保障水平低和覆盖面窄。同时,经过20余年的改革和发展,公立医疗机构过度商业化,医疗市场结构扭曲,卫生资源配置不合理,医疗服务供给效率低下,进一步恶化了医疗保障状况。
中国医疗保障制度不但直接受到医疗改革影响,还间接受到医学模式的影响——医学模式通过与医疗改革的互动对医疗保障制度产生重大影响。总的来看,现代社会的医学模式正在由重事后治疗转向重事前预防,由此引发了医疗领域的健康革命,我国的城镇基本医疗保险正在向基层向社区倾斜,社区卫生服务迅速发展。同时,医学模式的转变也大大提高了中医药在提高国民健康水平中的地位。
在上述的医学模式转变与卫生改革背景下,论文研究了中国医疗保障制度的四个层面。城镇基本医疗保险是医疗保障的主体,文章在既有的研究基础上重点分析了现代医学模式对其影响;医疗保障制度的创新研究重点放在商业健康保险(医疗保障制度的必要补充)、医疗救助(医疗保障制度的最后防线)和新型农村合作医疗(医疗保障制度的延伸)上。最后,在上述研究基础上,文章把医疗保障和卫生改革所涉及的主体全部纳入到医疗市场中,从第三方管理(TPA)的角度进行了博弈分析,研究了市场结构创新对医疗资源运用效率的增进机制。
文章创新之处主要表现:(1)分析了我国公立医疗机构过度商业化的特征,揭示了现行医疗保障体制的内在缺陷,对未来中国医疗保健市场进行了预测。(2)从医疗服务的公共服务产业角度出发,研究了中国医疗服务的市场结构完善,提出通过培育医疗市场的第三方管理者(TPA)推动市场结构创新,促使公共服务产业发展的改革思路。(3)分别从城市贫困人口、社区残疾人、遭遇突发事件三个角度对医疗救助问题进行深入剖析,并结合杭州西湖区的案例研究提出了政策建议。
The health economics from 1960's has maken a deep research into the medical care system, playing the emphasis on analyzing its efficiency and equity. At one time, the major western countries have developed diversified and sophisticated institutions of social security system, accumulating lots of experience on medical security system reform. So, China can draw lesson to enhance her medical care system innovation from the theatric and practical rich harvest mentioned above.
China's medical care system has its own characteristics and consists of four aspects: fundamental medical security in cities, new rural cooperative medical care system, medical assistance, commercial insurance on health care. Considering present situation, because of historical reasons and economy develop level, the main problems include low security standards and narrow coverage. At the same time, after more than 20 years' reformation and development, the new medical system problems come forth which include over commercialized, medical market structure distorted, medical recourses unjustly allocated, and medical service supply with low efficiency, all of which worser the situation of medical security.
Medical security is affected not only by Health system reformation directly, but also by the model of medical science indirectly. The interactions between medical reformation and the model of medical science influences medical security system greatly. General speaking, the model of medical science in modern society changes from emphasizing on medical treatment afterward to medical prevention beforehand, inducing health revolution. As a result, fundamental medical security in cities in China is attaching weight to community, health service in community is developing rapidly, and the status of Chinese traditional medicine is being improved greatly.
Under the background of heath system reformation and medical science model transition, this paper makes a research into the 4 aspects of medical security system in China. Fundamental medical security in cities is the main body of medical security system, this paper just points out the influence of medical science model transition upon it. This paper just pays emphasis on the following 3 aspects: new rural cooperative medical care system, which is the extend of medical security; medical assistance, which is the end line of defense of medical security; commercial insurance on health care, which is the necessary supplement of medical security. On the basis of the above investigation, this paper puts the interest parties involved in the medical security and health reformation into the medical market, makes a research with the game theory from the point of view of third party administration(TPA), which investigates the mechanism of enhancement medical market innovation upon medical resources utilization efficiency.
引文
[1]王利明.消费者的概念及消费者权益保护法的调整范围.政治与法律,2001(2)
[2]王利明.民法典侵权责任法研究.北京:人民法院出版社,2003.460-441
[3]杨紫煊.经济法.北京:北京大学出版社、高等教育出版社.2000.201
[4]杨秀仪.论医疗伤害赔偿责任适用消费者保护法之争议.见:民法七十年之回顾与展望纪念论文集.台湾:元照出版公司,2000.249
[5]Arrow,K.J..Uncertainty and the Welfare Economics of Medical Care.American Economic Review,1963,53(5):941-973
[6]Fuchs.Economics,Values,and Health Care Reform.American Economic Review,1963,86(1):1-24
[7]Fuchs,Victor R..The Future of Health Economics.Journal of Health Economics,2000,19(2):141-157
[8]Fuchs,Victor R..The Health Sector's Share of the Gross National Product.Science,1990(8):247:534-8
[9]Fuchs,Victor R.Health,Government and Ivring Fisher.NBER working paper.6710.1993
[10]Iglehart.The American Health Care System:Expenditures.New England Journal of Medicine,Health,1990,340(1):70-76
[11]Culyer,Anthony J.and Joseph P.Newhouse.Introduction:The State and Scope of Health Economics.in Culyer and Newhouse ed.Handbook of Health Economics,Amsterdam:Elsevier,2000,1A:1-8
[12]Culyer,A.J.and J.P.Newhouse.Handbook of Health Economics,Amsterdam:Elsevier,Volume 1A and 1 B,2000
[13]Feldstein,Martin.The Economics of Health and Health Care:What Have We Learned? What Have I Learned?.American Economic Review,1995,85(2):28-31
[14]Feldstein,Martin.The Welfare Loss of Excess Health Insurance.ournal of Political Economy,1973,81(2):251-80
[15]Grossman,M.The Demand for Health:A Theoretical and Empirical Investigation. Journal of the Royal Statistical Society.Series A(General),1974,37(2):279-280
[16]Grossman,M.The Human Capital Model of the Demand for Health.in Anthony C.and J.Newhouse,editors,Handbook of Health Economics,Amsterdam,New York:Elsevier,2000
[17]Pauly,M.V..Nonprofit Firms in Medical Markets.American Economic Review,1987(May):257-274
[18]Newhouse,J.P.Toward a Theory Nonprofit Iinstitutions.American Economic Review,1970(March):604-713
[19]休·史卓顿,莱昂内尔·奥查德.公共物品、公共企业和公共选择--对政府功能的批评与反批评的理论纷争.北京:经济科学出版社,2000
[20]张金钟.医学模式转变中的道德问题.中华医院管理杂志,2000(1)
[21]高梦滔.美国健康经济学的发展.经济学动态,2002(8)
[22]维克托,R,福克斯.谁将生存?健康,经济学和社会选择.(第一版).罗汉,焦艳,朱雪琴.上海:上海人民出版社,2000:50-55
[23]Becker,Gary.Human Capital:A Theoretical and Empirical Analysis,with Special Reference to Education.Chicago:Chicago University Press,1964
[24]张金钟.医学模式转变与医学道德进步.医学与社会,1999(3)
[25]Aaron,J,Henry.Book Review Handbook of Health Economics.Journal of Health Economics,2001,20(6):847-854
[26]Arrow,K,J.Uncertainy and the Welfare Economics of Medical Care.American Economy Review,1963,53:941-967
[27]Bolin,Kristian et al.The Family as the Health Producer-When Spouses Are Nash-bargainers.Journal of Health Economics,2000(September):349-362
[28]Jonathan Gruber.Saving Babies:The Efficacy & Cost of Recent Changes In The Medical Eligibility of Pregnant Women.Journal of Political Economy,1996,104:1261-1296
[29]Culyer,J,Anthony.Preface.in:Anthony J.Culyer and Joseph P.Newhous.Handbook of health economics.New York:Elsevier,2000,1A:2
[30]Dolan,P.The Measurement of Health-Related Quality of Life.in:Anthony J.Culyer and Joseph P.Newhouse.Handbook of health economics.New York: Elsevier,2000,1 B:749-1755
[31]仇雨临.加拿大社会保障制度对中国的启示.中国人民大学学报,2004(1)
[32]Fuchs,Victor R.Economic Aspects of Health.Chicago:Chicago Press,1982:12-15
[33]Grossman,Michael.The Demand for Health:A Theoretical and Empirical Investigation.New York:Columbia University Press For The National Bureau of Economic Research,1972:3-10
[34]Grossman,Michael,Joyce,Theodore.Unobservable,Pregnancy Resolutions,&Birthweight Production Functions in New York City.NBER working Paper,1998(October):26-30
[35]Mushkin,S,J.Health as an investment.Journal of Political Economy,1962(70)
[36]Newhouse,E Joseph.Toward A Theory Nonprofit Institutions.American Economy Review,1970(March):604-713
[37]Pauly,v,Mark..Nonprofit Firms in Medical Markets.American Economic Review,1987(Ma):257-274
[38]Rutten,Frans et al.Book Review Handbook of Health Economics.Journal of Health Economics,2001(June):855-879
[39]Scitovsky,A,Anni.Changes in The Cost Treatment of Selected Illnesses,1956-65.American Economy Review,1967(1.57):1183-1195
[40]约翰,G.库里斯,皮特,A,威斯特.卫生经济学概论.(第一版).北京:北京医学院卫生经济学研究会.中国展望出版社,1983:118-119
[41]张群.美国的医疗保险制度现状及引发的思考.中国卫生经济,2007(6)
[42]张建国.国外主要医疗保险模式分析.山东劳动保障,2007(5)
[43]Grossman,Michael,Joyce,Theodore.Unobservable,Pregnancy Resolutions,&Birthweight Production Functions in New York City.NBER working Pape,1988(October):26-30
[44]李莉.近现代西方残疾人社会福利保障的价值理念及实践启示.中国特殊教育,2007(6)
145]苏理.国外农民医保模式一瞥.当代广西,2007(8)
[46]Newhouse,P,Joseph.Toward A Theory NonprofitInstitutions.American Economy Review,1970(March):604-713
[47]Pauly,V,Mark.Nonprofit Firms in Medical Markets.American Economic Review,1987(May):257-274
[48]郑大喜.医疗保险对医院经营的影响及其应对策略.中华医院管理杂志,2004(6):349-350
[49]郑大喜.医保支付制度改革与医院成本核算发展趋势探讨.中国卫生经济,2005(6):60-62
[50]赵林海等.现代医学模式对我国社会医疗保险可持续发展的启示.中国卫生经济,2005(7):27-29
[51]世界银行.1993年世界发展报告:投资于健康.北京:中国财政出版社,1993:52-60.108-133
[52]WHO.Macroeconomics and Health:Investing in Health for Economic Development-Report of the Commission on Macroeconomics and Health.World Health Organization,Geneva.2001:62-69
[53]石光.我国区域卫生规划政策的实施效果评价.中国卫生经济,2005(7):11-14
[54]杜治政.21世纪医学发展的若干问题.中华医学杂志,1999(1):7-9
[55]郑大喜.市场机制、政府调节与医疗管制制度框架的构建.医学与哲学,2004(9)
[56]张德元.农村医疗保障:出路何在.经济学家,2003(3)
[57]王延中.新世纪中国农村医疗保障制度的发展方向和政策建议.中国卫生经济,2003(8):37-38
[58]郑焕清.芬兰:注重全民参与平等分享.社会保障制度(人大复印资料),2001(11):56-57
[59]穆怀中.社会保障国际比较.北京:中国劳动社会保障出版社,2002:202-204,216
[60]陈德君,罗元文.日本医疗保险制度及其对我国的启示.日本研究,2002(3):52-58
[61]樊明.健康经济学-健康对劳动市场表现的影响.北京:社会科学文献出版社,2002:12-19.21-26
[62]王延中.新世纪中国农村医疗保障制度的发展方向和政策建议.中国卫生经济,2003,22(8):37-38
[63]郑焕清.芬兰.注重全民参与平等分享.社会保障制度(人大复印资料), 2001(11):56-57
[64]穆怀中.社会保障国际比较.北京:中国劳动社会保障出版社,2002:202-204,216
[65]陈德君,罗元文.日本医疗保险制度及其对我国的启示.日本研究,2002(3):52-58
[66]马安宁,孟庆阳.新型农村健康保健模式及效果评价.中国卫生经济,2003(7):12-14
[67]高书生,关于搭建中国社会保障新平台的设想.经济研究参考,2003(4):25-35
[68]杨冠群.当代美国社会保障制度.北京:法律出版社,2001.126-310
[69]马宏坤.美国医疗费用控制策略.中国卫生经济,2002(2):45-46
[70]仇雨临,孙树菡.医疗保险.北京:中国人民大学出版社,2001:95-100
[71]刘典恩.发展和谐医患关系与医疗秩序重构.医学与哲学(人文社会医学版),2007(3)
[72]毕芳.美国医疗救助制度沿革及其对我国的启示.中国卫生资源,2007(1)
[73]TimE.Health economics in low income countries:Adapting to the reality of the un-official economy.Health Policy,2001(57):1-13
[74]Janet Huntn McCool,DawnM Bishop.Health economics and the economics of education:Specialization and divi2sionoflabor.Economics of Education Review,1998(97):237-244
[75]G.E.Enge.需要新的医学模式:对生物医学的挑战.医学与哲学,1980(3)
[76]张金钟.医学模式转变与医学道德进步.医学与社会,1999(3):76
[77]巴尔等.福利经济学前沿问题.北京:中国税务出版社,2000
[78]保罗.J.费尔德斯坦.卫生保健经济学.费朝晖,李卫平,王梅,汪宏,吴明.北京:经济科学出版社,1998
[79]陈智明.医疗保险学概论.深圳:海天出版社,1995
[80]成思危.中国社会保障体系的改革与完善.北京:民主与建设出版社,2000
[81]邓大松.社会保障若干重大问题研究.深圳:海天出版社,2000
[82]劳动和社会保障部医疗保险司.中国医疗保险制度改革政策与管理.北京:中国劳动社会保障出版社.1999
[83]世界银行.中国:卫生模式转变中的长远问题与对策.北京:中国财政经济出 版社,1994
[84]赵林海.现代医学模式对我国社会医疗保险可持续发展的启示.中国卫生经济,2005(7)
[85]张光鹏.现代医学模式下我国卫生服务模式的研究进展/中国医院管理,2005(6)
[86]彭纯清.新医学模式在社区医疗服务中的应用探讨.南华大学学报(医学版),2007(2)
[87]粟芳.收入分配的公平性与保险市场发展的关联分析.财经研究,2004(1)
[88]张金林.中国人身保险市场发展的国内环境透视.管理世界,2005(6)
[89]陈朝先.人身保险.北京:中国金融出版社,1998
[90]刘京生.知识经济与保险.北京:中国社会科学出版社,2001
[91]郑功成,社会保障学.北京:商务印书馆,2000
[92]张清彩,发展商业寿险完善社会保障体系闭.保险研究,2001(11)
[93]邓大松,刘大平.二十一世纪世界社会保障制度发展趋势田.江西财经大学学报,2003(01)
[94]冯乃宪.论商业健康保险的发展.保险研究,2002.(1)
[95]吕岩.国外商业医疗保险发展与我国医疗产品的开发.保险研究,2002(11)
[96]朱晓枫,冯珂.我国商业医疗保险发展契机浅析.经济师,2004(2)
[97]李琼.中国商业健康保险发展研究,经济评论,2004(4)
[98]国务院发展研究中心.中国医疗卫生体制的目标定位问题,农村医疗保障制度改革应当调整思路.中国发展评论,2005(3)
[99]迈克尔,C.杰克逊.系统思考--适于管理者的创造性整体论.中国人民大学出版社.2005
[100]杨团,毕天云.陕西省洛川县旧县镇基本卫生服务统筹试点研究报告.见:中国农村卫生体系与政策国际研讨会,2005.8
[101]杜乐勋等.中国医疗卫生产业发展报告.北京:社科文献出版社,2004
[102]奥斯特罗姆等.美国的地方政府.北京:北京大学出版社,2004
[103]亚诺什,科奈尔等.转轨中的服务、选择和一致性.北京:中信出版社,2003
[104]乔治·索罗斯.开放社会:改革全球资本主义.北京:商务印书馆,2002
[105]杨团.社区公共服务论析.北京:华夏出版社,2002
[106]杨团.反思农村新型合作医疗政策.中国社会科学,2005(1)(英文版)
[107]李卫平.中国农村健康保障的选择.北京:中国财政经济出版社,2002
[108]马尔科姆-沃特斯.现代社会学理论.北京:华夏出版社,2001
[109]埃利诺,奥斯特罗姆.公共事物的治理之道.上海:上海三联书店,2000
[110]周浩杰.新型农村合作医疗制度:经验、挑战和对策.中国卫生经济,2005(1)
[111]刘洁.论政府在弱势人群医疗救助中的主体地位.中国卫生经济,2006(7)
[112]顾昕,方黎明.自愿性与强制性之间-中国农村合作医疗的制度嵌入性与可持续性发展分析.社会学研究,2004(5)
[113]朱玲.农村健康服务与公共支持.http://www.cc.org.cn/wencui/030922200/0309222004,htm
[114]李小华.国外医疗救助政策比较.卫生经济研究,2006(10)
[115]王冬等.现代医学管理理论与方法.上海:上海科学技术文献出版社,1992
[116]张金钟.医学模式的转变在实践上为何滞后.医学与哲学杂志,2000(5)
[117]段文辉.构建医疗救助体系打通城镇低保对象就医绿色通道--以伊犁州低保人群综合医疗保险为例.新疆金融,2007(4)
[118]崔璐.论发展我国的医疗救助制度.中国初级卫生保健,2006(10)
[119]谌立平.城市贫困人群的医疗救助问题研究.特区经济,2006(12)
[120]王延中.试论国家在农村医疗卫生保障中的作用.战略与管理,2001(3)
[121]丁红梅.现阶段中国农村医疗保障制度初探.前沿,2004(1)
[122]张德元.农村医疗保障:出路何在.经济学家,2003(3).
[123]王延中.试论国家在农村医疗卫生保障中的作用,战略与管理,2001(3)
[124]王云帆.浙江“赤脚医生”消失之后.21世纪经济报道,2002-7-8.
[125]薛小和.逐步建立农民基本医疗保障制度--访中国社会科学院科研局副局长王延中.经济闩报,2002-09-12
[126]《中国卫生年鉴》编辑委员会.中国卫生年鉴.2004-2006.北京:人民卫生出版社
[127]《中国医院年鉴》编辑部.中国医院年鉴.2004-2006.北京:中国协和医科大学出版社
[128]中国卫生事业发展情况统计公报.2002-2006.http://www.moh.gov.cn/12.htm
[129]WHO.世界卫生报告.2004-2006.http://www.who.int/whr/previous/en/index.html
[130]刘典恩.发展和谐医患关系与医疗秩序重构.医学与哲学(人文社会医学版),2007(3)
[131]毕芳.美国医疗救助制度沿革及其对我国的启示.中国卫生资源,2007(1)
[132]李小华.国外医疗救助政策比较.卫生经济研究,2006(10)
[133]郭军强.英国医疗保健制度的特征及对我国的启示.中国全科医学,2007(9)
[134]吴少林.医疗体制改革与医院发展思考.现代医院,2007(4)
[135]许红.对医疗保险制度改革的几点思考.中国卫生经济,2007(5)
[136]梁鸿.中国基本医疗保险制度改革解析.复旦学报(社会科学版),2007(1)
[137]张会钟.医学模式的转变在实践上为何滞后.医学与哲学,1996(7)
[138]张余钟.促进医学模式在理论和实践上的转变.健康报,1996(12)
[139]冯学惠.试论新医学模式的形成和发展.解放军预防医学杂志,1995(6)
[140]焉然.医学模式转变过程中我国卫生事业的发展.中国初级卫生保健,2007(6)
[141]俞岚.现代医学模式下的医患关系和医院管理.重庆医学,2007(1)
[142]姜楠.医学模式的转变.大同医学专科学校学报,2004(4)
[143]孙秀清:论社会保障制度对人身保险发展的影响.山东经济,2004(6):128-131
[144]徐倩,谢勇,戴维周.基于健康经济学视角的中国医疗保障水平分析.财经研究,2003(12):45-49
[145]白维军.城市医疗救助制度实施中的问题分析与政策建议.中国民政,2007(6)
[146]农业部农业经济研究中心课题组.新型农村合作医疗和特困人口医疗救助相结合的制度建设.中国人口科学,2007(2)
[2]王利明.民法典侵权责任法研究.北京:人民法院出版社,2003.460-441
[3]杨紫煊.经济法.北京:北京大学出版社、高等教育出版社.2000.201
[4]杨秀仪.论医疗伤害赔偿责任适用消费者保护法之争议.见:民法七十年之回顾与展望纪念论文集.台湾:元照出版公司,2000.249
[5]Arrow,K.J..Uncertainty and the Welfare Economics of Medical Care.American Economic Review,1963,53(5):941-973
[6]Fuchs.Economics,Values,and Health Care Reform.American Economic Review,1963,86(1):1-24
[7]Fuchs,Victor R..The Future of Health Economics.Journal of Health Economics,2000,19(2):141-157
[8]Fuchs,Victor R..The Health Sector's Share of the Gross National Product.Science,1990(8):247:534-8
[9]Fuchs,Victor R.Health,Government and Ivring Fisher.NBER working paper.6710.1993
[10]Iglehart.The American Health Care System:Expenditures.New England Journal of Medicine,Health,1990,340(1):70-76
[11]Culyer,Anthony J.and Joseph P.Newhouse.Introduction:The State and Scope of Health Economics.in Culyer and Newhouse ed.Handbook of Health Economics,Amsterdam:Elsevier,2000,1A:1-8
[12]Culyer,A.J.and J.P.Newhouse.Handbook of Health Economics,Amsterdam:Elsevier,Volume 1A and 1 B,2000
[13]Feldstein,Martin.The Economics of Health and Health Care:What Have We Learned? What Have I Learned?.American Economic Review,1995,85(2):28-31
[14]Feldstein,Martin.The Welfare Loss of Excess Health Insurance.ournal of Political Economy,1973,81(2):251-80
[15]Grossman,M.The Demand for Health:A Theoretical and Empirical Investigation. Journal of the Royal Statistical Society.Series A(General),1974,37(2):279-280
[16]Grossman,M.The Human Capital Model of the Demand for Health.in Anthony C.and J.Newhouse,editors,Handbook of Health Economics,Amsterdam,New York:Elsevier,2000
[17]Pauly,M.V..Nonprofit Firms in Medical Markets.American Economic Review,1987(May):257-274
[18]Newhouse,J.P.Toward a Theory Nonprofit Iinstitutions.American Economic Review,1970(March):604-713
[19]休·史卓顿,莱昂内尔·奥查德.公共物品、公共企业和公共选择--对政府功能的批评与反批评的理论纷争.北京:经济科学出版社,2000
[20]张金钟.医学模式转变中的道德问题.中华医院管理杂志,2000(1)
[21]高梦滔.美国健康经济学的发展.经济学动态,2002(8)
[22]维克托,R,福克斯.谁将生存?健康,经济学和社会选择.(第一版).罗汉,焦艳,朱雪琴.上海:上海人民出版社,2000:50-55
[23]Becker,Gary.Human Capital:A Theoretical and Empirical Analysis,with Special Reference to Education.Chicago:Chicago University Press,1964
[24]张金钟.医学模式转变与医学道德进步.医学与社会,1999(3)
[25]Aaron,J,Henry.Book Review Handbook of Health Economics.Journal of Health Economics,2001,20(6):847-854
[26]Arrow,K,J.Uncertainy and the Welfare Economics of Medical Care.American Economy Review,1963,53:941-967
[27]Bolin,Kristian et al.The Family as the Health Producer-When Spouses Are Nash-bargainers.Journal of Health Economics,2000(September):349-362
[28]Jonathan Gruber.Saving Babies:The Efficacy & Cost of Recent Changes In The Medical Eligibility of Pregnant Women.Journal of Political Economy,1996,104:1261-1296
[29]Culyer,J,Anthony.Preface.in:Anthony J.Culyer and Joseph P.Newhous.Handbook of health economics.New York:Elsevier,2000,1A:2
[30]Dolan,P.The Measurement of Health-Related Quality of Life.in:Anthony J.Culyer and Joseph P.Newhouse.Handbook of health economics.New York: Elsevier,2000,1 B:749-1755
[31]仇雨临.加拿大社会保障制度对中国的启示.中国人民大学学报,2004(1)
[32]Fuchs,Victor R.Economic Aspects of Health.Chicago:Chicago Press,1982:12-15
[33]Grossman,Michael.The Demand for Health:A Theoretical and Empirical Investigation.New York:Columbia University Press For The National Bureau of Economic Research,1972:3-10
[34]Grossman,Michael,Joyce,Theodore.Unobservable,Pregnancy Resolutions,&Birthweight Production Functions in New York City.NBER working Paper,1998(October):26-30
[35]Mushkin,S,J.Health as an investment.Journal of Political Economy,1962(70)
[36]Newhouse,E Joseph.Toward A Theory Nonprofit Institutions.American Economy Review,1970(March):604-713
[37]Pauly,v,Mark..Nonprofit Firms in Medical Markets.American Economic Review,1987(Ma):257-274
[38]Rutten,Frans et al.Book Review Handbook of Health Economics.Journal of Health Economics,2001(June):855-879
[39]Scitovsky,A,Anni.Changes in The Cost Treatment of Selected Illnesses,1956-65.American Economy Review,1967(1.57):1183-1195
[40]约翰,G.库里斯,皮特,A,威斯特.卫生经济学概论.(第一版).北京:北京医学院卫生经济学研究会.中国展望出版社,1983:118-119
[41]张群.美国的医疗保险制度现状及引发的思考.中国卫生经济,2007(6)
[42]张建国.国外主要医疗保险模式分析.山东劳动保障,2007(5)
[43]Grossman,Michael,Joyce,Theodore.Unobservable,Pregnancy Resolutions,&Birthweight Production Functions in New York City.NBER working Pape,1988(October):26-30
[44]李莉.近现代西方残疾人社会福利保障的价值理念及实践启示.中国特殊教育,2007(6)
145]苏理.国外农民医保模式一瞥.当代广西,2007(8)
[46]Newhouse,P,Joseph.Toward A Theory NonprofitInstitutions.American Economy Review,1970(March):604-713
[47]Pauly,V,Mark.Nonprofit Firms in Medical Markets.American Economic Review,1987(May):257-274
[48]郑大喜.医疗保险对医院经营的影响及其应对策略.中华医院管理杂志,2004(6):349-350
[49]郑大喜.医保支付制度改革与医院成本核算发展趋势探讨.中国卫生经济,2005(6):60-62
[50]赵林海等.现代医学模式对我国社会医疗保险可持续发展的启示.中国卫生经济,2005(7):27-29
[51]世界银行.1993年世界发展报告:投资于健康.北京:中国财政出版社,1993:52-60.108-133
[52]WHO.Macroeconomics and Health:Investing in Health for Economic Development-Report of the Commission on Macroeconomics and Health.World Health Organization,Geneva.2001:62-69
[53]石光.我国区域卫生规划政策的实施效果评价.中国卫生经济,2005(7):11-14
[54]杜治政.21世纪医学发展的若干问题.中华医学杂志,1999(1):7-9
[55]郑大喜.市场机制、政府调节与医疗管制制度框架的构建.医学与哲学,2004(9)
[56]张德元.农村医疗保障:出路何在.经济学家,2003(3)
[57]王延中.新世纪中国农村医疗保障制度的发展方向和政策建议.中国卫生经济,2003(8):37-38
[58]郑焕清.芬兰:注重全民参与平等分享.社会保障制度(人大复印资料),2001(11):56-57
[59]穆怀中.社会保障国际比较.北京:中国劳动社会保障出版社,2002:202-204,216
[60]陈德君,罗元文.日本医疗保险制度及其对我国的启示.日本研究,2002(3):52-58
[61]樊明.健康经济学-健康对劳动市场表现的影响.北京:社会科学文献出版社,2002:12-19.21-26
[62]王延中.新世纪中国农村医疗保障制度的发展方向和政策建议.中国卫生经济,2003,22(8):37-38
[63]郑焕清.芬兰.注重全民参与平等分享.社会保障制度(人大复印资料), 2001(11):56-57
[64]穆怀中.社会保障国际比较.北京:中国劳动社会保障出版社,2002:202-204,216
[65]陈德君,罗元文.日本医疗保险制度及其对我国的启示.日本研究,2002(3):52-58
[66]马安宁,孟庆阳.新型农村健康保健模式及效果评价.中国卫生经济,2003(7):12-14
[67]高书生,关于搭建中国社会保障新平台的设想.经济研究参考,2003(4):25-35
[68]杨冠群.当代美国社会保障制度.北京:法律出版社,2001.126-310
[69]马宏坤.美国医疗费用控制策略.中国卫生经济,2002(2):45-46
[70]仇雨临,孙树菡.医疗保险.北京:中国人民大学出版社,2001:95-100
[71]刘典恩.发展和谐医患关系与医疗秩序重构.医学与哲学(人文社会医学版),2007(3)
[72]毕芳.美国医疗救助制度沿革及其对我国的启示.中国卫生资源,2007(1)
[73]TimE.Health economics in low income countries:Adapting to the reality of the un-official economy.Health Policy,2001(57):1-13
[74]Janet Huntn McCool,DawnM Bishop.Health economics and the economics of education:Specialization and divi2sionoflabor.Economics of Education Review,1998(97):237-244
[75]G.E.Enge.需要新的医学模式:对生物医学的挑战.医学与哲学,1980(3)
[76]张金钟.医学模式转变与医学道德进步.医学与社会,1999(3):76
[77]巴尔等.福利经济学前沿问题.北京:中国税务出版社,2000
[78]保罗.J.费尔德斯坦.卫生保健经济学.费朝晖,李卫平,王梅,汪宏,吴明.北京:经济科学出版社,1998
[79]陈智明.医疗保险学概论.深圳:海天出版社,1995
[80]成思危.中国社会保障体系的改革与完善.北京:民主与建设出版社,2000
[81]邓大松.社会保障若干重大问题研究.深圳:海天出版社,2000
[82]劳动和社会保障部医疗保险司.中国医疗保险制度改革政策与管理.北京:中国劳动社会保障出版社.1999
[83]世界银行.中国:卫生模式转变中的长远问题与对策.北京:中国财政经济出 版社,1994
[84]赵林海.现代医学模式对我国社会医疗保险可持续发展的启示.中国卫生经济,2005(7)
[85]张光鹏.现代医学模式下我国卫生服务模式的研究进展/中国医院管理,2005(6)
[86]彭纯清.新医学模式在社区医疗服务中的应用探讨.南华大学学报(医学版),2007(2)
[87]粟芳.收入分配的公平性与保险市场发展的关联分析.财经研究,2004(1)
[88]张金林.中国人身保险市场发展的国内环境透视.管理世界,2005(6)
[89]陈朝先.人身保险.北京:中国金融出版社,1998
[90]刘京生.知识经济与保险.北京:中国社会科学出版社,2001
[91]郑功成,社会保障学.北京:商务印书馆,2000
[92]张清彩,发展商业寿险完善社会保障体系闭.保险研究,2001(11)
[93]邓大松,刘大平.二十一世纪世界社会保障制度发展趋势田.江西财经大学学报,2003(01)
[94]冯乃宪.论商业健康保险的发展.保险研究,2002.(1)
[95]吕岩.国外商业医疗保险发展与我国医疗产品的开发.保险研究,2002(11)
[96]朱晓枫,冯珂.我国商业医疗保险发展契机浅析.经济师,2004(2)
[97]李琼.中国商业健康保险发展研究,经济评论,2004(4)
[98]国务院发展研究中心.中国医疗卫生体制的目标定位问题,农村医疗保障制度改革应当调整思路.中国发展评论,2005(3)
[99]迈克尔,C.杰克逊.系统思考--适于管理者的创造性整体论.中国人民大学出版社.2005
[100]杨团,毕天云.陕西省洛川县旧县镇基本卫生服务统筹试点研究报告.见:中国农村卫生体系与政策国际研讨会,2005.8
[101]杜乐勋等.中国医疗卫生产业发展报告.北京:社科文献出版社,2004
[102]奥斯特罗姆等.美国的地方政府.北京:北京大学出版社,2004
[103]亚诺什,科奈尔等.转轨中的服务、选择和一致性.北京:中信出版社,2003
[104]乔治·索罗斯.开放社会:改革全球资本主义.北京:商务印书馆,2002
[105]杨团.社区公共服务论析.北京:华夏出版社,2002
[106]杨团.反思农村新型合作医疗政策.中国社会科学,2005(1)(英文版)
[107]李卫平.中国农村健康保障的选择.北京:中国财政经济出版社,2002
[108]马尔科姆-沃特斯.现代社会学理论.北京:华夏出版社,2001
[109]埃利诺,奥斯特罗姆.公共事物的治理之道.上海:上海三联书店,2000
[110]周浩杰.新型农村合作医疗制度:经验、挑战和对策.中国卫生经济,2005(1)
[111]刘洁.论政府在弱势人群医疗救助中的主体地位.中国卫生经济,2006(7)
[112]顾昕,方黎明.自愿性与强制性之间-中国农村合作医疗的制度嵌入性与可持续性发展分析.社会学研究,2004(5)
[113]朱玲.农村健康服务与公共支持.http://www.cc.org.cn/wencui/030922200/0309222004,htm
[114]李小华.国外医疗救助政策比较.卫生经济研究,2006(10)
[115]王冬等.现代医学管理理论与方法.上海:上海科学技术文献出版社,1992
[116]张金钟.医学模式的转变在实践上为何滞后.医学与哲学杂志,2000(5)
[117]段文辉.构建医疗救助体系打通城镇低保对象就医绿色通道--以伊犁州低保人群综合医疗保险为例.新疆金融,2007(4)
[118]崔璐.论发展我国的医疗救助制度.中国初级卫生保健,2006(10)
[119]谌立平.城市贫困人群的医疗救助问题研究.特区经济,2006(12)
[120]王延中.试论国家在农村医疗卫生保障中的作用.战略与管理,2001(3)
[121]丁红梅.现阶段中国农村医疗保障制度初探.前沿,2004(1)
[122]张德元.农村医疗保障:出路何在.经济学家,2003(3).
[123]王延中.试论国家在农村医疗卫生保障中的作用,战略与管理,2001(3)
[124]王云帆.浙江“赤脚医生”消失之后.21世纪经济报道,2002-7-8.
[125]薛小和.逐步建立农民基本医疗保障制度--访中国社会科学院科研局副局长王延中.经济闩报,2002-09-12
[126]《中国卫生年鉴》编辑委员会.中国卫生年鉴.2004-2006.北京:人民卫生出版社
[127]《中国医院年鉴》编辑部.中国医院年鉴.2004-2006.北京:中国协和医科大学出版社
[128]中国卫生事业发展情况统计公报.2002-2006.http://www.moh.gov.cn/12.htm
[129]WHO.世界卫生报告.2004-2006.http://www.who.int/whr/previous/en/index.html
[130]刘典恩.发展和谐医患关系与医疗秩序重构.医学与哲学(人文社会医学版),2007(3)
[131]毕芳.美国医疗救助制度沿革及其对我国的启示.中国卫生资源,2007(1)
[132]李小华.国外医疗救助政策比较.卫生经济研究,2006(10)
[133]郭军强.英国医疗保健制度的特征及对我国的启示.中国全科医学,2007(9)
[134]吴少林.医疗体制改革与医院发展思考.现代医院,2007(4)
[135]许红.对医疗保险制度改革的几点思考.中国卫生经济,2007(5)
[136]梁鸿.中国基本医疗保险制度改革解析.复旦学报(社会科学版),2007(1)
[137]张会钟.医学模式的转变在实践上为何滞后.医学与哲学,1996(7)
[138]张余钟.促进医学模式在理论和实践上的转变.健康报,1996(12)
[139]冯学惠.试论新医学模式的形成和发展.解放军预防医学杂志,1995(6)
[140]焉然.医学模式转变过程中我国卫生事业的发展.中国初级卫生保健,2007(6)
[141]俞岚.现代医学模式下的医患关系和医院管理.重庆医学,2007(1)
[142]姜楠.医学模式的转变.大同医学专科学校学报,2004(4)
[143]孙秀清:论社会保障制度对人身保险发展的影响.山东经济,2004(6):128-131
[144]徐倩,谢勇,戴维周.基于健康经济学视角的中国医疗保障水平分析.财经研究,2003(12):45-49
[145]白维军.城市医疗救助制度实施中的问题分析与政策建议.中国民政,2007(6)
[146]农业部农业经济研究中心课题组.新型农村合作医疗和特困人口医疗救助相结合的制度建设.中国人口科学,2007(2)
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