摘要
以1883年引进的强制医疗保险制度为主干的德国医疗保障体制是全球仿效最多的成功模式。但近年来随着德国经济增长的趋缓、老年化的加剧以及全球化的冲击,该体制在财政、社会团结和医疗服务提供效率等方面的问题日益凸现,成为默克尔政府经济社会改革的重点。本文在简要介绍德国医疗保障体制的现状和基本框架、问题及其成因的基础上,分析了默克尔政府医改的背景、德国各政党不同的改革草案及其背后的理念差异,评析了最终正式出台的改革法案的主要内容,指出这次以加强竞争为主要手段、涉及领域空前广泛、多目标的改革在方向上无疑是正确的。但作为一个大联合政府的多方妥协的方案,实施结局如何尚难预料。
German Health Care System, which is mainly founded on the Compulsory Health Care System imported by Bismarck dated to 1883, is a successful model most widely imitated throughout the world. However, along with the slowing down of German economic growth, the deterioration of the aging of population and the impacts of globalization, the systematic problems of financing, social solidarity and efficiency of health care provision have gradually emerged. The reform of the health care system seems inevitable and becomes the focus of the economic and social reforms implemented by the Merkel government. But there remain broad controversies as to the concrete steps to take. Based on the introduction of the status quo and the basic structure of German Health Care System, the paper analyzes the background of the health care reform carried out by the Merkel government, the different reform protocols proposed by different parties and the different notions underlying each protocol. This paper also comments on the main contents of the final act titled 'Health Care Reform 2007', and points out the validity of the general aim of this reform which uses competition enhancement as the main instrument, covers unprecedented broad fields and which is oriented to multiple objectives. However, as a programme resulted from compromises by different parties, it is difficult to foresee its final result, which may not be positive.
出处
《欧洲研究》
CSSCI
北大核心
2007年第6期106-119,共14页
Chinese Journal of European Studies
