近代江南市镇人口与城镇化水平变迁

本文准备讨论的问题是：（１）从总体看，自前近代延续而来的江南市镇人口聚集规模与其结构，在近代社会转轨过程中有何变化？（２）近代江南市镇人口聚集规模与其结构的变化，又在多大程度上影响了本地区城镇化水平的提高？这两个方面是决定市镇现代化水平的基本因素。     

当前我国健康投资模式选择

国家投资于公共卫生和基本医疗保健,不仅可以节约大量的卫生开支,而且能够普遍改善基层卫生设施和居民健康状况.中国在"人人享有卫生保健"的最低目标基本实现后,随着经济发展和居民收入的增长,中国政府应该选择新的健康投资模式,重点投资领域为艾滋病防治,医学研究,健康教育与传染病、非传染慢性病预防,改善健康环境、培训初级卫生保健人员等.向这些领域投资,既能改善公平又能提高效率,有利于增加人力资本存量.     

人道主义与经济合理性

人道主义标准与经济效益物质资源的增加远不是人道主义社会发展的唯一条件,而只是前提之一。因此,经济政策以面向发展生产、提高生产效益、把握达到这些目的的杠杆为方针,对卓有成效的社会发展来说还不充分。重要的是,这些杠杆本身在多大程度上同时符合社会标准,在多大程度上它们的利用会导致积极的社会进步,而不是在社会发展的道路上设置障碍。这里产生了一个对社会主义命运来说极为重要的问题。从纯经济角度看,那些限制实现社会要求的可能性甚至违背人道主义标准的提高生产的经济效益的扛杆,是不是要比与这些要求和标准相协调     

2005-2014年镇江市卫生资源配置公平性研究

通过Gini系数和Theil系数研究新医改对镇江卫生资源配置公平性的影响,发现现存问题并提出政策建议。方法:利用以往有关卫生资源配置公平性的文章进行文献综述,并采用Gini系数和Theil指数对2005-2014年十年间的相关统计数据进行研究;结果:Gini系数和Theil指数在近十年间基本保持较低水平且基本呈下降趋势,特别是2009年以后Gini系数减幅明显,但是Theil系数仍反映镇江市各行政区之间卫生资源配置仍存在不均衡现象;结论:通过Gini系数的计算可以得出:镇江市卫生资源分布公平性保持在一个较佳状态且近年来改善较显著,另外,在对镇江市机构床位数、医生数、护士数三种卫生资源的Gini系数和Theil指数的分析中还发现,2009年之后三种卫生资源配置公平性改善尤为明显,这可能与新医改的推行和政策稳定、卫生投入增加有关。     

基于省会城市的中国医疗资源递减配置及其制度分析

公共品服务的均等化是社会和谐稳定的内在要求。当前我国卫生医疗资源配置不均衡是资源配置不公的主要现象之一。从省域范围来看,不均衡不仅表现为城乡差异,而且医疗资源依省会城市、地级城市与县级城市的行政级别呈递减配置,这种按权力大小来配置公共资源的体制与公共服务的公平性目标相矛盾。     

国家控制与医生临床自主性的滥用:对公立医院医生执业行为的分析

如何对医生的执业行为实施有效的社会控制是职业社会学的一个重要问题。本文通过对我国城市医生的执业环境与执业行为的分析,指出医生仍然依附于占据医疗服务市场垄断地位的公立医院,丧失法团自主性的他们无法与国家就收入与服务补偿进行协商。但也正是由于垄断地位,公立医院及其医生获得了对患者和医药厂商的双向支配地位,可以便利地将处方权转换为经济利益。但与此同时,医生对临床自主性的这种滥用意味着卫生行政部门的监管、职业规范内化后的自律等社会控制方式的失败。本文认为,医生这一职业群体在医疗卫生政策制定过程中的参与、逐步开放医生的执业自由以及给予非公立医疗机构平等的地位与待遇等措施会使这些问题得到改观。     

社会医疗保险对老年人健康水平的影响：基于浙江省的实证研究

本研究根据2010年浙江省城乡老年人口生活状况调查的数据认为,对于老年人的社会医疗保险问题,不仅要关注保险覆盖面的扩大,更应关注不同保险项目参保老人之间的健康平等。在揭示医疗服务使用与健康水平负向关系这一主效应的基础上,研究发现,职工医保作为moderator可以改善使用较多医疗服务老人的健康水平,新农合的作用则相反。研究希望对医疗保险的改革思路进行反思,全民医保的改革思路不仅是医疗服务可及性的提高,更应该是不同社群享有平等的医疗福利,并最终促进健康结果的平等。     

日本经济新双重结构理论

最近,日本经济内部的各种失调引起了人们的关注。显然,其起因是石油危机的影响。那么这些问题是怎样反映在劳动力结构方面的呢?笔者想在此提出双重结构重新出现的假说。双重结构理论,是一个老问题了,它是战后高速度增长的出发点。这一问题最先是有泽广巳教授提出的,他说:“军事占领结束时,首先考虑在战后复兴中,工人的状况在多大程度上得到了改善。劳资双方在法律上虽然是平等的,但事实是工人和民众的生活并没有好转。这是为什么?很大的原因     

社会服务组织筹资机制研究

目前我国社会服务组织的筹资面临着一系列的问题,无论是筹集到的资金的数量,还是筹资的方式,抑或者是筹资的评估机制都令人堪忧。导致目前社会服务组织筹资能力不足的原因内部外部兼而有之,可以归纳为宏观社会背景和微观组织能力两个方面。宏观上来说,我国社会公民的公益意识还不够普及,     

城中村已婚流动女性卫生服务需求及政策分析——以昆明市为例

“城中村”是城市化进程中的特殊现象,流动人口多因城中村便宜的住房而聚居于此。笔者调查的城中村社区已婚流动妇女因自身保健知识及居住环境所限,缺乏公共卫生服务的公平性和可及性,严重地影响了流动已婚妇女的健康。本文就更好地实现“城乡统合”、“人人享有卫生保健”提出行政管理的讨论与建议。     

Policy Changes in Community Mental Health: Interventions and Strategies Used in Sweden over 20 Years

The deinstitutionalization of mental health care has changed the responsibilities of involved authorities and has led to a continuous need for new treatment forms and interventions. This article describes this development in Europe, and in particular how these new conditions have been handled in Sweden over the past 20 years at the level of governmental policy‐making. Three major policy documents from 1994, 2009 and 2012 were included in this study. To increase our understanding of the policies' contents, we have used theoretical concepts concerning governance, implementation and political risk management. Although our main interest was to find out how the government handles interventions for users of the mental health care system, we found that the policy work is progressing stepwise. The first document, from the deinstitutionalization era, did not discuss interventions clearly. Instead, it was mainly concerned with both practical and economical areas of responsibility. The second document, from the post‐deinstitutionalization era, was more focused on what services should be delivered to the users, while the most recently published document to a greater extent addressed the question of how the support is supposed to be designed. The trend in European community mental health policy has been to advocate services in open forms that are integrated into the society's other care systems. This is also the case in Sweden, and continuous work is being done by the government to find strategies to support the development, and to meet the needs at both political and local levels.     

Urban community in China: service, participation and development

With the rapid urbanisation and population growth in the cities, the People's Republic of China has recognised the importance of community development based on an ever-increasing demand for social services. In 1994, the Chinese government adopted community service as an alternative way of providing the supplemental safety net in urban areas. Along with this top-down approach, resident-initiated activities, participation and grassroots organisations at the community level are growing at an incredible pace. Using a case study, this study explores the context and aspects of community services, participation and community development in a Chinese urban community. Results indicate that China's reformed market economy and welfare system presses ordinary urban people to reconnect to the local community to ensure welfare security and quality of life. Community participation in China has rediscovered the path of community development and re-interpreted the top-down and bottom-up approaches in the context of community services.     

Land Finance and the Tax-sharing System： An Empirical Interpretation

地方政府的区域竞争推动了中国经济的迅速增长,其中的作用机制有待发掘。地方政府行为受中央与地方关系的影响,尤其受分税制以来财税体制改革的影响。分税制集中财权使地方政府逐渐走向以土地征用、开发和出让为主的发展模式,从而形成了土地财政;利用省级的年度数据验证了两者之间的密切关系。无论如何评价以土地财政为代表的发展模式,与财政包干制相比,分税制都是一个理性化的制度变革,其建立了中央与地方之间关系的稳定互动框架,而以土地为中心的城市扩张模式是这次改革的意外后果。     

The implementation and development of child welfare and protection works in China

The Chinese government adheres to the principle of ‘children first’ and actively protects their rights of survival, development, protection and participation through methods such as laws and regulations, policy system, public services and pilot works. The Chinese government aimed to narrow the gap between children's development in rural and urban areas and to continuously improve the level of child welfare. The government complies fully with its responsibilities in raising the overall quality of life for children and improving their health and overall development.

China has 280 million children, and is the country with the most children in the world. China is a signatory of and a country that loyally implements the Convention on the Rights of the Child. Since the economic reform, China's economy has developed rapidly, politics has been harmonized and stabilized, and the degree of social civilization has risen continuously. At the same time, work on children has also achieved remarkable accomplishments in China.     

Household assets and health in China: evidence and policy implications

China's health care reform of the 1990s has not yielded much success. The market‐oriented health system has resulted in declines in fairness of health services and efficiency of investment in the health sector. Further health care reform will be required. Among many options, asset‐based policy has demonstrated some potential in domestic policy development. To provide evidence to inform health policy development in China, this study focuses on the effects of household assets on health in China. Specifically, the current study examines how household assets may affect health status and how assets differ from income in predicting health status. Using a random sample of Chinese elderly, we find that asset holding in the form of household durables and household utilities has both direct and indirect effects on health status. Household assets directly affect access to medical care and indirectly affect health by influencing health behaviour and psychological condition. In other words, in addition to economic effects, household assets appear to have behavioural and psychological effects on health. Interestingly, these effects appear to be associated with assets, but not with income. Implications for asset building policy are suggested as a complement to existing health care models.

中国自20世纪90年代开始的卫生保健改革还没有取得很大成功。市场主导的医疗系统使卫生部门提供的健康服务无论在公平性和效率都有所下降。进一步的医疗保健改革是需要的。在众多的选择当中，以资产为基础的政策已显示出一定的潜力。为向中国的卫生政策发展提供证据，这项研究的重点是家庭资产在中国对健康的影响。具体来说，目前的研究探讨家庭资产如何影响健康状况，以及资产如何不同于收入来预测健康状况。作者用随机抽样的方法研究中国的老年人，发现家庭耐用消费品和家庭水电费都直接和间接影响健康状况。家庭资产直接影响到能否获得医疗照顾和间接影响有关影响健康的行为和心理状态。换言之，除了经济影响，家庭资产似乎对行为和心理健康有所影响。有趣的是，这些影响似乎是与资产相关，而并非收入。作者建议以资产建设政策补充现有的医疗保健模式。     

From State Security Model to Selective + Residual Security Model: Health care regime shift in urban China

Based on the study of welfare states, welfare regime theory (WRT) has been widely applied to international and regional welfare regimes and to specific‐policy comparative studies. However, the health care system has often been neglected in this area of study. The current study promotes a health care regime approach that is influenced by WRT and incorporates analysis of the level of health care de‐commodification and health equity. Three types of health care regimes were identified in the development of the health care system in urban China: the State Medical Security Model, the Selective Medical Security Model and the Selective + Residual Medical Security Model. This approach provides useful policy implications for the health care reform currently taking place in China. In addition, this analysis contributes to theories in the comparative health policy literature.     

The health care system of the People's Republic of China: Between privatization and public health care

Chinese health care policy has undergone numerous reforms in recent years that have often led to new challenges, inciting the need for further reform. The most recent reforms attempt to find a middle path between public health care provision and commercial private insurance. In this way, China is following in the footsteps of countries that initially increased the role of privatization in the 1990s and at the beginning of the 21st century, but are now gearing towards public health care. However, this process of constant reform has led to a lack of transparency in the functioning of the health care system, provoking a loss in public trust. There remains an important degree of uncertainty about the future direction of developments in China. Nonetheless, a dual financing approach to health care using tax finance and social insurance might yet crystallize, offering a potential model to inform developments in other countries.     

Development of Social Health Insurance in Mongolia: Successes, Challenges and Lessons

This paper examines the process of developing social health insurance in Mongolia, and its successes, challenges and lessons. The government of Mongolia introduced social health insurance in 1994, which is compulsory for all public and private sector employees and low-income and vulnerable population groups. The scheme also provided voluntary insurance for unemployed people of working age. About 95 per cent of the population was covered by health insurance within the first two years thanks to a high level of government subsidy for vulnerable population groups. The insurance benefit initially covered nearly all inpatient services except the treatment of some specified chronic and infectious diseases, which were directly funded by the government. The scheme not only had many successes but also faced challenges in maintaining universal coverage. The new financing arrangement has provided little financial incentive for healthcare providers to contain health expenditure, contributing to rapid health cost inflation. In addition to reforming the payment system for providers, there has been an increasing need to expand benefits into ambulatory care. The development of compulsory health insurance in Mongolia shows that a prepaid health insurance mechanism based on risk sharing and fund pooling is feasible in low-income countries given political commitment and government financial support for vulnerable population groups.     

The extent and limits of solidarity in Dutch health care

Solidarity and equal access are twin principles in the Dutch health care system: solidarity between the rich and poor and among people with high and low risks formally guarantees equal access to health care services. However, in the past few years government policies, guided by the ideology of market reform and free choice, have resulted in patterns of inequality that favour privately insured over sickness fund insured. In the meantime, the level of public support for the principles of solidarity and equal access is dropping. A significantly larger portion of the Dutch people now believes that it would be too costly to grant everyone the right to all medical treatments possible. An important reason for the decline of solidarity and equal accessibility is the scarcity of resources. The scarcity of resources and the waiting lists resulting from it will reduce the extent of the benefits package and the access to the care services of the health system. The better-off will have the resources to receive care services that are not part of the basic package. Moreover, the scarcity of resources will affect the readiness in society to provide informal care. Opposed to the compulsory macro solidarity of the health insurance system, informal care is based on a voluntary kind of solidarity in which personal choice plays an important role. Waiting lists and diminishing professional support weaken this readiness, as such support is a necessary condition for informal carers to keep caring for their relatives and friends. Because the informal care system is a necessary supplement to the formal system of care, the lack of help offered by the latter will in the end endanger the solidarity not only in informal care, but in the institutional care system as well.     

户口还起作用吗?——户籍制度与社会分层和流动(英文)

户籍制度是中国社会一项基本的制度安排,它把户口作为资源配置和利益分配的重要凭据,对社会分层和流动产生了较大的影响。在改革开放近三十年后,中国的户口还起不起作用,以及起着怎样的作用？通过对综合社会调查数据的分析,发现中国社会分层具有城乡户口差别和城市户口等级差别并存的特点,户口转变和迁移的开放性程度与个人社会流动机会获得有正相芙关系。市场转型虽带来了较多流动机会,但户口等级差别以及户口对体制内流动所起的结构性影响依然存在。鉴于户籍制度的强粘附性生成了社会差别,改革这一制度的基本方向是推行户口一元化和迁移自主化。