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目前,中国公共财政体系建设“不约而同”成为社会结构转型、深化政治经济和社会管理体制改革、建设公共服务型政府和实现公共服务均等化、构建和谐社会的核心议题。只有清晰明确的公共政策与繁荣发达的公共经济,稳固、均衡、雄厚、透明的公共财政体制,才有现代公共服务型政府和全民性公共服务体系。公共财政范围与类型界定是基础性议题,本文将公共财政范围界定为国家所有公共支出的结构性体系,将公共财政类型区分为广义、中观、狭义三大类型,将三大类型的公共财政细分为国家财政、政府财政、国防财政、外交财政、科技财政、福利财政、公共住房财政、教育财政和卫生财政等基本类型,以此体现其结构性特征。在此基础上,本文探讨卫生财政体制面临的结构性困境,探讨卫生财政结构调整困境的成因,并以医药卫生体制改革和医疗卫生服务为领域,探讨健康照顾服务均等化和制度创新问题。
At present, the construction of China’s public finance system has become the core issue of restructuring the social structure, deepening the reform of the political, economic and social management systems, building a public service-oriented government, and equalizing public services and building a harmonious society. Only a clear and definite public policy and prosperous public economy, a stable, balanced, strong and transparent public financial system, only modern public service-oriented government and universal public service system. Defining the scope and type of public finance is the basic issue. In this paper, the scope of public finance is defined as the structural system of all public expenditures in the country. The public finance is divided into three types: broad, medium and narrow. The three types of public finance Subdivided into the basic types of national finance, government finance, defense finance, diplomatic finance, science and technology finance, welfare finance, public housing finance, education finance and health finance, in order to reflect its structural characteristics. On this basis, this paper explores the structural dilemmas faced by the health financing system and explores the causes of the structural adjustment of the health financing system. It also explores the equalization of health care services and institutional innovation in the field of medical and health system reform and medical and health services.