Community Health Service In The Government Under The Contract System Governance Perspective Purchase

Government-purchasing of community health service is a new mode of public service supply, and is a new idea, method or mechanism's transform of public products and services supply, which is based on the background of a new health-care reform, and conformed to the market reform. It has important significance to solve the public health service demand of grassroots effectively and realize community public health service to equal access. At present, the government purchasing pattern is still in the pilot phase in China. Although most people has accepted it in concept already, it did not achieve the desired policy goal in practice. Now, it is still in a imbalance position between supply and demand of community health services.Contract system is a governance tool blended with more market spiritual, which has applied more and more in public management to improve the efficiency of supplying public products and service. Based on the perspective of contract system, this paper discussed government-purchasing process of community health service. By getting the elements during the process of government-purchasing community health service under the perspective of contract governance, we discussed the interaction of the main body and their relations. Government-purchasing of community health service constructed multi-layer principal-agent relationship between government, officials, agencies and the community residents. Because of the phenomenon of noncooperative games including the unsmooth newly-formed management relations, asymmetry information, inconformity interests function, imperfect supervision and auditing system, and the incomplete of purchase contract itself, it may produce a series of problems, such as ambiguity of power and duties, lack of the competition mechanism, responsibility and commitment risk, moral hazard and adverse selection, etc.The construction of contract governance framework of government-purchasing of community health service cannot be accomplished but rooted in the social practice. We need to think rationally on how to deal with all kinds of risks in the contract governance to government-purchasing of service in practice. Combined with case analysis, this article raised to reform administrative system and integrat governmental roles, formulate constraint rules, construct a competitive partnership, set up multi-dimensional security system, establish the selective benefit mechanism, establish supervisory and performance evaluation system of contract, and then promote contract management of government-purchasing of community health service to the benign circulation rail development, and push forward community health service supply subjects to be multiple coexist and competitive, to drive community health service development, and meet the needs of the community residents.