On The Reform Of The Rural Township Health Centers And The Orientation Of Government Responsibility

Purpose:As the center of the tertiary prevention and health care network,the rural health center is of profound significance in the reforming of the township health service system.According to The Decision on Promoting The Township Health Services(hereinafter referred to as "the Decision")issued by the Central Committee of the Communist Party of China and the State Council on October 19,2002,the township health center shall be organized by the government and shall focus on providing the public health services;therefore,the reform of rural health centers led by the government started up.However,how does the government play its leading role? In which way could the government organize the township health centers? Due to the insufficient basic theoretical research,the government's way to play its leading role has not been determined during the implementation.Hence,by selecting "On the Reforming of Township Health Services and Government's Orientation" as the title,this paper will set off a comprehensive research from multi-angle views by applying the theories of health economics, health service management,public finance and science of law,which is of theoretical significance and practical value—first,provide the theoretical basis with the government's leading role in the reform of the township health services;second,design and provide the available operation methods with the implementation of reform of township health services and government's leading role;third,provide the decision-making reference to further perfect the policy,the construction and stability of reform of township health services;fourth,create a bridge among health economics,health service management,public finance and science of law.Methods:Try to extract the cross-disciplinary research methods of health economics,health service management,health law,science of society and public finance;from the view angle of health economics and health service management and applying the methods of integration of theory and practice,social investigation and case analysis,this Paper will carry on the profound and systematical discussion and research.Conclusion:According to this Paper,the function and the present situation of the township health services shall be clear before implementing the reform.In China,township health service centers were established during the planned economy system.From the cstablishment,the related policy and documents of CPC have determined the township health service center shall focus on providing the public health service,integrating the prevention,health care and basic medical services,as well as the public health management function entrusted by the county-level health administrative departments.However,during the transitional period of the economy system,due to the decline of the collective economy support under the original planned economy system,the financial support from the county-level has decreased or terminated.After the self reform and exploration,the present situation of the township health service centers are as follows: one third operates well;one third bears a loss but is surviving;one third has closed down. Nowadays,the government's leading role has been determined during the reform of the township health service centers,as well as the orientation of the reform—the township health service centers shall focus on providing the public health service and shall be organized by the government.According to this Paper,the measure to ensure the smooth reform is that the government shall construct the reform system and then lead the township health service center to carry out the smooth reform.Since the township health service center cannot select the health system by itself,which consists of a series of policy and regulations.The determination of the new health system demands the support of the new policy,but also the construction of a series of laws and regulations,namely,the detailed regulation group and the system chain;otherwise,the reform of the township health service center will lose its orientation. The reform of the township health service center shall be launched from 3 views:(1)from the macro-view,the government shall work out the regulation group and the system chain for the new health system so as to determine the outline and the detailed contents of the new health system;meanwhile,the construction of the township health service centers shall combine with the regional health resource layout;(2)from the middle-view,the township health service center organized by the government shall be in accordance with the reform of public financial construction;furthermore,led by the new-type rural cooperative medical service,the fund-raising mode of the township health service centers shall be reformed;according to the actual situation of Chinese rural health service,the contradiction of the fund-raising channel between the pure public health service and the quasi public health service shall be coordinated; (3)from the micro-view,supposing the township health service center as a public-interest legal person,explore its internal and external control(the supervision and management mode of the administrative supervisor)structure,which shall enhance the supervision efficiency of the county-level health bureau;furthermore,as the independent legal person,the competitive system shall be introduced into the township health service centers to ensure its high-efficiency operation.