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不少决策者最初认为汶川大地震会阻碍中国卫生改革进程,但事实上,针对地震的应急反应和灾后重建为加速卫生体制改革营造了一个机遇。更重要的是,可以利用这个机会在四川和周边省份建立更好的卫生体系。但是,新近颁布的四川地震灾区重建规划关注重点是基础设施。笔者认为更好的做法或许是在重建的同时有效解决卫生行业目前面临的主要问题,即政策协调和实施、制定规制及执行、筹资与治理。与卫生改革宗旨协调一致的卫生重建方案至少应包括三个方面:实现医保全民覆盖、加强初级卫生服务和公共卫生服务、改革基本医疗卫生服务提供体系。
Many policymakers initially thought the Wenchuan earthquake would hinder China’s health reform process, but in fact, the response to the earthquake and post-disaster reconstruction have created an opportunity to speed up the reform of the health system. More importantly, this opportunity can be used to establish a better health system in Sichuan and the surrounding provinces. However, the newly promulgated Sichuan earthquake-stricken area reconstruction plan focuses on infrastructure. The author believes that a better approach may be to effectively solve the major problems currently facing the health sector while rebuilding, namely, policy coordination and implementation, regulation and implementation, fund-raising and governance. The health reconstruction program coordinated with the purpose of health reform should at least include three aspects: to achieve health insurance universal coverage, to strengthen primary health services and public health services, and to reform the system of providing basic medical and health services.