我国城乡基本医疗服务均等化理论基础.doc

摘要近年来，随着改革开放的步伐加快，我国GDP平均增长率大幅上升， 经济发展取得了耀眼的成绩随着综合国力显著提高，人民的生活质量也随 之进步然而，虽然人民的生活质量在很大程度上得到了提高，但是国民的 福利并没有得到普遍的提升我国经济的突飞猛进，随之而来的是老百姓对 科技、教育、医疗卫生等各项基本公共服务需求越来越迫切，如果这些问题 解决不好，势必会影响我国全面建设小康社会和构建和谐社会的进程为了 实现人人平等的享右基本民疗服务这一远大H标，2009年4月国务院审议 并通过了《关于深化医药卫生体制改革的意见》及《医药卫生体制改革近期 重点实施方案2009-2011年》，该意见提出了我国应该逐步实现城乡基本医 疗服务均等化并明确了政府应在基本医疗服务过程中起主要作用但是随着 医疗改革的逐步推行，近年来，基本医疗服务资源配置存在的问题仍然十分 严峻，突出表现就是基本医疗服务资源在城乡之间分配的不公平，这不仅存 损于公平和平等，同时偏离城乡统筹、城乡和谐发展的轨道，与胡锦涛总书 记在十八大提出的“城乡经济社会发展一体化”重大战略部署相背可见， 优化城乡医疗服务配置是我国目前医改的重中之重本文首先利用经济学以及医学等学科的相关理论对基本医疗服务、均等 化和基本医疗服务均等化等概念进行界定。

其次，通过对比我国中、东、西 部基本医疗资源配置情况来说明目前基本医疗服务领域中存在的不均等现 象，并具体到甘肃省，对其城乡基本医疗服务均等化进程中出现的问题进行 全面、系统的剖析最后，针对这些问题，在中国城市和农村基本医疗服务 均等化的实现过程中提出科学的政策建议，即通过借鉴吸收国外先进医疗服 务经验、改变原存“城乡二元结构”、加速政府职能转变以及健全完善相应 法律法规等一系列措施来有效地推进甘肃省基本医疗服务均等化的实现，促 进社会和谐稳定发展关键词：城乡；基本医疗服务；均等化；甘肃省AbstractDuring the 30 years of reform and opening up，the economic construction of China has attracted worldwide attention with an average GDP annual growth rate of 9.8%. Besides, the great improvement of comprehensive national strength has driven up people’s living standard. However, this economic performance has improved people’s living standard to some extent, but it failed to improve national welfare generally. With the development of China social economy, social members are in urgent need of their various basic rights and interests in science and technology, education, medical treatment and public health as well as social security and so on. If not solved properly, these problems will be bound to hinder the process of building well-off society in an all-round way and building a harmonious society, the two national development goals of China. In order to enable everyone to get access to basic medical service, the State Council of China deliberated and approved “CPC Central Committee and the State Council: Opinions on Deepening Medical and Health System Reform” and “2009-2011 Key Embodiment of Medical and Health System Reform” in the April of 2009. The new healthcare reform scheme proposed the policy goal of ‘‘accelerating the equalized basic public health service between urban and rural residents” step by step and identified the dominant role of the government in providing basic medical care and health service. However, in recent years, along with the gradual implementation of healthcare reform, there are a lot of serious problems in the resource allocation of basic healthcare service, which are fullyreflected in the unfair resource allocation of the basic medical service betweenurban and rural residents. This kind of unfairness is not only detrimental to social fairness and equality, but also derived from the track of overall urban-rural development and the harmonious development of urban and rural areas. In addition, it also goes against the strategic deployment of “integrating the economic and social development of urban and rural area” proposed in the Third Plenary Session of the Seventeenth Central Committee. It is obvious that optimizing the allocation of medical service of urban and rural areas is an important aspect of basic medical service reform of China.In this paper, firstly, Economics and Medical Science were associated to define basic medical service, equalization and the equalization of basic medical care. Secondly, the inequality of basic medical resources at present was illustrated through comparing the medical resource allocation in central China,east China and west China, and then an overall and systematic analysis was made on the current situation of the equalization of basic medical care in urban and rural areas of Gansu Province in order to find out the causes of stagnation. Finally, specific to these problems, scientific policy suggestions were proposed to promote the equalization of basic medical care in urban and rural areas,namely effectively boosting the realization of equalized basic medical care by drawing advanced experience from foreign countries, changing the “urban-rural dual structure” and accelerating the transformation of government functions as well as perfecting the corresponding laws and regulations, so as to promote the harmonious and stable development of the society.Key words : Urban and rural； basic medical service； equalization； GansuProvince目录绪i仑 10第一节选题背景以及意义 10一、 选题背景 10二、 选题意义 11第二节城乡医疗卫生服务均等化相关研究综述 14一、 国外研究综述 14二、 国内研宄综述 15第三节研究内容、思路以及方法 18一＞研究rt容与思路 18二、研宄方法 19第二章我国城乡基本医疗服务均等化理论基础 19第一节城乡基本医疗服务均等化的概念 19一、均等化的含义 20二、 基本医疗服务 20三、 城乡基本区疗服务均等化 22第二节基本医疗服务均等化的经济学基础 23一、 福利经济学理论 23二、 公共财政理论 错误!未定义书签。

三、 公共产品理论 错误!未定义书签四、 罗尔斯的正义理论 错误!未定义书签第三节我国城乡基本医疗服务相关制度 错误!未定义书签一、 国家基本药物制度 错误!未定义书签二、 基木医疗保险制度 错误!未定义书签第三章我国城乡基本医疗服务配置的现状----以甘肃为例错误!未定义书签第一节我国基本医疗服务配置的现状 错误!未定义书签一、 我国东、中、西部基本医疗服务配置状况比较错误!未定义书签二、 甘青宁地区基本医疗服务配置状况比较••…错误!未定义书签第二节甘肃城乡基木医疗服务配置的均等化现状••错误!未定义书签二、甘肃省基本医疗服务城乡配置状况 错误!未定义书签第四章甘肃城乡基本医疗服务非均等化的原因 错误!未定义书签第一节省内区域经济发展不均衡 错误!未定义书签第二节公共财政支出不合理 错误!未定义书签一、转移支付制度不合理 错误!未定义书。