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发帖数: 8702 | 1 下面是Grigoriou, C., Guillaumont, P., & Yang, W. Y. 2005论文里对改革开放后卫
生服务的评价。
在改革接轨时代，农村居民以及城市贫民获得医疗服务变得日益困难，原因在于农村合
作医疗体系坍塌，财政去中心化，以及医疗体制改革，这三个因素都导致了医疗服务成
本提高，面向大众服务的医疗机构无论数量还是质量双双下降。
首先来看农村合作医疗制度。1970年代末到1980年代中期，由于农村取消合作化，农村
合作医疗制度被釜底抽薪，变成无米之炊。由于缺乏资源，农村合作医疗制度土崩瓦解
。这导致了农村绝大多数人口失去了任何形式的医疗保险，看病吃药全靠个人掏腰包。
祸不单行的是，1980年代末，药品价格大幅上涨，1987-1989年期间，药品价格上涨幅
度超过了物价上涨水平，增幅高达51%，而同期全国零售物价指数上涨了37%。
原文：
During this reform and transition period, access to health services by rural
residents and urban poor has become more problematic. This resulted from
the collapse of the rural collective health system and from fiscal
decentralization and health sector reforms, all of which were combined to
increase costs to service users while also adversely affecting the number
and quality of institutions delivering services to the masses. First, the
economic basis of the rural cooperative medical system collapsed as the
rural economy was decollectivized during the late 1970–mid 1980s period.
Deprived of resources, the rural cooperative health care system started to
disintegrate. This left the majority of the rural population without any
forms of health insurance and they had to begin paying for health services
out-of-pocket. Moreover, at the end of the 1980s the price of
pharmaceuticals
increased more rapidly than the general level of price rising by more than
51% from 1987 to 1989, compared to 37% for the national retail price index (
cf. National Bureau of Statistics, 1990)
Grigoriou, C., Guillaumont, P., & Yang, W. Y. 2005. Child mortality under
Chinese reforms. China Economic Review, 16(4): 441-464. |
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