走向全民健康保险:论中国医疗保障制度的转型

中国已经进入全民医保的时代,但医疗保障体系呈现碎片化的特征,其内部的若干制度安排之间出现了不协调。中国医疗保障体系亟待进一步转型,转型的重点和方向是将基本医疗保障体系从现行分散化、碎片化的社会医疗保险制度,改造为集中化、一体化的社会医疗保险制度,即全民健康保险。推进全民健保是"发展型社会政策"的体现,具有同时促进经济增长和社会发展的双重功效。从短期来看,这是一种简单易行而又可持续的减税计划,可以促进经济增长,有助于经济发展模式的转变;从长远来看,全民健保制度的建立标志着"社会性基础设施"的建设又迈上了一个新的台阶,这必将为中国福利国家的重建奠定基础。     

以公共价值为基础的政府绩效治理——源起、架构与研究问题

政府绩效管理兴起二十多年来,已由西方国家应对财政和信任危机、提高行政效率的工具拓展为各国政府改革和创新的重要内容,新公共管理的实践价值和理论优势在其中都得到了充分体现。但其理论缺陷和实践中的困惑,特别是在公共价值方面的冲突使学术界的探索从未停止过。本文通过对中国、美国、日本等国的实践案例考察,从制度变迁和公共行政学术史两个层面的质性研究,提出了以公共价值为基础的政府绩效治理理论体系框架。文章首先从"公共性"、"合作生产"和"可持续"三个方面对新公共管理背景下的政府绩效管理进行了反思,认为公共价值对政府绩效合法性具有本质的规定性。其次,初步论证了以公共价值为基础的政府绩效治理的两个基本命题——政府绩效是一种社会建构、产出即绩效;认为只有来源于社会的政府绩效才能获得合法性基础,也只有根植于社会的政府绩效才能产生其可持续提升的需要,这是政府绩效管理的根本动力;而在政府绩效价值建构基础上的科学管理,才能保证政府产出与社会需求的高度一致,充分体现科学管理的价值。再次,从这两个基本命题出发,以价值管理和管理科学理论为基础,构建起了以公共价值为基础的政府绩效治理模型,并对模型中政府绩效的价值建构、组织管理和协同领导系统等主要内容进行了阐述。最后,从模型如何"落地"、政府绩效管理的价值分析和研究拓展等方面提出了未来的研究方向。     

制度能力与治理绩效——以上海社区为例

本文考察了社区治理绩效的影响因素.通过对上海45个小区调查数据的统计分析,文章发现居委会的制度能力与社区治理绩效之间存在显著的关系.居委会动员社区外资源的能力有助于提高其服务效率、居委会直选投票率,居委会与物业之间的合作关系也有助于提高直选投票率.该研究发现意味着,随着住房市场化和封闭式小区的出现,传统的基于楼组长动员网络的社区治理技术面临挑战,居委会有必要采取新的社区治理实践和技术来强化其制度能力的建设,从而更好地服务、管理社区.本文将制度能力作为一种分析工具引入城市社区治理的研究,丰富了社区治理研究的理论视角.同时,本文认为今后的研究需要进一步完善居委会制度能力的测量指标,并进一步阐明制度能力影响治理绩效的作用机制.     

论现代危机下的公民责任

现代化是一个充满风险的过程,危机将是现代社会的常态。公民的责任能力对于抗击现代危机的意义重大,在一定程度上决定着战胜危机的成败走向,关系着政府危机领导的效果。公民参与危机治理的公共事务是公民内在的职责,因为公民身份本身就包含着责任。公民积极主动的责任观念使参与危机的治理成为公民内在的自由要求。公民责任能力的提高需要教育引导和政治环境的熏陶。公民责任是与公民权利相联系的责任,责任之中包含着权利分享之义。     

公共危机治理中的政府信息公开与治理效度——基于一项调查实验

高质量公共信息在政府与民众间的开放及流动,不仅在国家治理体系中扮演着重要角色,更对政府提升危机应对能力起到关键作用.在本次新冠疫情防治中,各地基本做到了及时公开权威性信息,但信息公开程度有所差异,这对民众的风险防范行为和疫情防治效度产生了重要影响.目前对信息公开与治理效度的研究在理论上缺乏因果机制分析,在方法上依赖观察...     

A training approach for community maternal health volunteers that builds sustainable capacity

This article examines a training approach for community health volunteers which increased access to maternal health services in rural communities in Zambia. The effectiveness of the training approach was evaluated in an operations research component. Skilled birth attendance rates increased by 63% from baseline over a two-year period in the intervention districts, out-performing increases recorded in control sites at statistically significant levels. As a low-cost, high-impact intervention which shows good sustainability potential, the approach is suitable for national level scale-up and for adaptation for use in other countries in support of maternal and new-born health goals.     

A note on household approach to credit rationing in agrarian economies

Using clues from transaction cost economics this note develops an intertemporal agricultural household model to explain the demand-side credit rationing from formal financial institutions in agrarian economies. The model employs ex-ante transaction costs, namely search cost and negotiation cost to explain this phenomenon. The model shows that with market failure an agricultural household's production decision is not separate from its consumption decision. This is when the policy analysis household approach, which includes simultaneous decision making in production and consumption side, becomes essential.     

Supporting local climate adaptation planning and implementation through local governance and decentralised finance provision

Policies developed at national levels can be unresponsive to local needs. Often they do not provide the rural poor with access to the assets and services they need to allow them to innovate and adapt to the ways that increased climate variability and change exacerbate challenges to basic securities – food, water, energy, and well-being. In development deficit circumstances, common pool resources are important for climate adaptation purposes. In order for climate adaptation actions to deliver resilience, local perspectives and knowledge need to be recognised and given due priority in formal planning systems. Basing formal adaptive development planning on local strategies can support and strengthen measures that people have been tested and know to work. Local climate adaptation through collective action can address current increases in climate variability, future incremental changes, and the need to transform existing systems to deal with qualitative shifts in climate. These types of adaptation can work in cumulative ways. The results of local adaptation collective action that have benefits of low rivalry between users while being highly inclusive can be considered “local public goods”. Evidence is beginning to emerge that when local governance systems facilitate high levels of participation in planning collective action for climate adaptation, and direct access to resources for implementing local plans, “local public goods” can be created and common pool resources better managed.     

Climate resilience in fragile and conflict-affected societies: concepts and approaches

To understand resilience to climate and environmental changes in fragile and conflict-affected societies is particularly important but equally challenging. In this paper, we first develop a conceptual framework to explore the climate-fragility-conflict and climate-resilience-peace nexus. Second, we discuss approaches to promote pathways from climatic changes to peace. We draw on the relevant literature and International Alert's experience in fragile and conflict-affected societies to stress the key role of resilience. To build resilience, climate, development, peacebuilding, and government actors would have to overcome bureaucratic and institutional barriers and cooperate across thematic and regional silos.     

Under-development in practice: Nigeria and the enduring problem of corruption

Nigeria's abundant natural resource endowments should earn the country's bragging rights as the “Giant of Africa”. Instead, 52 years of corrupt practices among the often recycled ruling elites in post-independence Nigeria have crippled this giant and turned what should be one of the country's strongest assets – its vast oil wealth – into a curse. This article critically examines the concerns for corruption as an enduring obstacle to Nigeria's development writ large. After providing a historical trajectory of corrupt practices in Nigeria from the mid-1980s to the present, it discusses some of the recent corruption scandals in the country, in particular the issues surrounding the US$6.8 billion that was drained from Nigeria between 2009 and 2012 in the fuel subsidy scam. The conclusion makes a case for the reworking of a pervasive system in Nigeria that “pardons” corruption and “recycles” corrupt rulers.