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目前国际上基本医疗卫生服务筹资模式主要有四类:社会保险型、国家保健型、商业医保型、保健储蓄账户型。这四种模式在筹资渠道、筹资标准和筹资挑战方面具有高度同质性,在筹资主体责任划分、筹资公平、可及和效率性方面则表现出高度异质性。国家型筹资模式强调政府责任,注重筹资公平与可及,但忽视了筹资利用效率;社会保险型筹资模式强调筹资的社会责任,兼顾了筹资公平与可及,但筹资利用效率较低;商业医疗保险型筹资模式强调筹资个体责任,追求筹资效率,但忽视了筹资利用公平与可及;储蓄账户型筹资模式强调责任共担,追求筹资利用的可及,但有失筹资公平与效率。
At present, there are mainly four types of financing modes for basic medical and health services in the world: social insurance, national healthcare, commercial healthcare and health care savings accounts. These four models are highly homogeneous in terms of funding channels, funding criteria and funding challenges, and exhibit a high degree of heterogeneity in the allocation of fund-raising responsibilities, equity, access and efficiency of funding. The state-owned financing model emphasizes the government’s responsibility, pays attention to the fairness and accessibility of financing, but ignores the efficiency of fund-raising and utilization. The social insurance-based financing mode emphasizes the social responsibility of raising funds while taking into account the fairness and accessibility of financing, but the efficiency of financing is low. Commercial medical Insurance-based financing model emphasizes individual responsibility for financing, the pursuit of fund-raising efficiency, but ignores the fair use of financing and access; savings account-based financing model emphasizes shared responsibility, the pursuit of financing is available, but the lack of equity and efficiency of financing.