The Research On Risk Prevention And Control Of Purchasing Basic Medical Services By The Government In China

The reform of basic medical services is one of the most complicate and difficult points in the reform of basic public services in our country.Since the central government deepened the reform of the medical and health system in 2009,the pace of reform in the field of medical services has accelerated noticeably.In fact,the government's purchase of basic medical services have become important measures for public services reform.From a realistic point of view,the purchase of basic medical services by the government has great operability in alleviating the contradictions of insufficient resources,resolving uneven development and inefficiency in China's basic medical services.However,the operating of reforms in the field of basic medical service both at home and abroad also shows that government's purchases are equally likely to fail,just as the practice of government purchases in other basic public services.Obviously,the basic medical services play an irreplaceable role in protecting people's livelihood.Once the government purchases fail,the impact will be broader and the public response will be even more fierce.Therefore,the research on risk prevention and control of purchasing basic medical services have an great theoretical as well as practical significance.At present,the overall amount of research on risk prevention and control of basic medical services purchased by the government is relatively small.The existed researches have mainly focused on the fields of medical and health system reform,such as disease programs and types of medicine,which lacks an analysis perspective on public administration.This study will build a research framework on the basis of combing the theoretical and practical background of government purchase of basic medical services and the comparative analysis of relevant research at home and abroad.Firstly,by distinguishing and defining the concepts of the basic medical services,the government purchase of basic medical services risk concepts and related theories,to build the research framework for this study.Secondly,the paper recall the effectiveness of the purchase of basic medical service in our country,and summarizes four kinds of risks in government purchasing basic medical service,that is to say,the accuracy is not high,the market is imperfect,the government is"captured",and the benefits are not good.The paper analyzed the reason from the aspects of system reform,the complexity of the subject relationship,the purchase payment method,the legal system,the supply-side defects,and the evaluation and supervision mechanism.This study selects the United Kingdom and Germany as research examples to provide experiences and lessons for the prevention and control of the government's purchase of basic medical services in our country.Finally,the paper proposes that the government should improve the government's purchase of basic medical services and reduce the risk of failure of purchasing from the aspects of deepening the reform of the system,being the "smart buyer",perfect the payment system,strengthening system guarantee,and improving the regulatory and evaluation mechanism.