泰国《全民健康保障法》及其对我国医疗保障立法的启示

泰国《全民健康保障法》为我国的医疗保障改革提供了可参考的样本.该法立足于泰国社会经济发展的现状,为所有国民提供了普遍的免费医疗保障.该法所建立的全民健康保险计划以一般税收作为资金来源,通过医疗资金管理者和医疗服务提供者的分离,以及按人头付费的方式,控制医疗成本.该法满足了全民的健康需求,提高了医疗服务的可获得性,促进了健康权利保障的平等性,保障了国民避免因病致贫的权利.我国的医疗保障改革应以公共税收作为全民医保的主要经费来源,以无差别的全民医保保障医疗权利的平等性,同时必须特别关注弱势群体的需求.     

The politics of health care regulation: the case of the National Health Planning and Resources Development Act

This paper examines the political and bureautic dynamics of health regulation under the National Health Planning and Resources Development Act and, to a lesser extent, the Carter Cost Proposal now before Congress. A number of underlying issues that affect the day-to-day exercise of health planning are considered, including the contest between state and local and federal government for program control, jurisdictional conflict between state and local planning agencies, and the unsettled roles to be played by professional planners, consumers, and providers. When we assess regulatory policy in health, these complicating factors must be added to the long list of handicaps that already exist. One important finding is that local planning agencies have embraced the task of health regulation somewhat more fully than had generally been expected. A number of explanations for this are offered. In short, the controlling factors in health planning are political, not technical, and there is more occurring at the state and local levels than many had predicted, although any impact is not likely to be dramatic.     

The Massachusetts Global Warming Solutions Act: A Very Shy Statute

When the Massachusetts legislature unanimously passed the Global Warming Solutions Act (GWSA) in 2008, the legislation was hailed as a groundbreaking and potent law that elevated Massachusetts to climate change leader status. However, while the law gave state agencies broad authority to make significant reductions in commonwealth greenhouse gas emissions, those state agencies have retreated from the GWSA's most powerful provisions. Undeniably, Massachusetts has made real greenhouse gas emissions cuts since 2008, but the ability of current programs to meet the GWSA's ambitious goals is becoming increasingly unlikely.     

Maternity care financing: universal access or universal care?

In an era of fiscal constraint, growing poverty, increased uninsuredness, medical liability problems, and increasing costs of maternity care, public and private financing mechanisms are changing rapidly and the service delivery system is increasingly fragmented. Despite the almost mercurial changes in the system, data from national studies show that access to care is a major problem affecting all childbearing women. This paper describes the three groups of women who require comprehensive maternity care, their insurance coverage, and the gaps for each group. It describes proposals which are currently under development to reduce uninsuredness and produce universal access and, in addition, presents an alternative plan for universal maternity care.