公共政策合法性供给机制与走向以医改进程为中心的考察

公共政策合法性不仅是一个重要的法治理论问题,也是法治秩序得以形成的重要变量。三十年来的"医改"进程表明,公共领域正在中国蓬勃兴起,并促进了公共政策合法性供给机制的时代转向,即从内部创议走向社会动员、从公众默认走向价值回归、从符合真理观走向共识真理观、从中心的内部循环走向中心与边缘的双向互动,展现着中国公共政策的重要民主化变革。虽然其中还存在着某些需要解决的问题,但它无疑构成了对多元和谐秩序的关键支撑和推进民主法治建设的新兴动力。

Legitimacy Supply Mechanism and Tendency in the Process of Medical Reform

The legitimacy of public policy is not only an important issue in the legal theory,but also a significant variable in the formation of the legal order.Policy evolution of China’s medical reform in the past 30 years indicates that the public sphere is in a boom in China,which has promoted the transformation of the legitimacy supply mechanism of public policy to a new age. Firstly,the mechanism has transformed from the previous model of "internal decision" to the mode of "social engagement",that is,to entrust some non-governmental organizations to develop medical reform plans and deliver the plans to the public for discussion,which can make the public policy formulation process full of brainstorm,critical reflection,dialogue,interactive debates and consultations,create a powerful "public opinion field",and promote the decision-making pattern to the contemporary democratic type.Secondly,the mechanism has transformed from the mode of "public default" to the mode of "value regression".The decision-making authority has altered the traditional mode of "leaders command,the masses follow",but based the decision on people’s demand and the practice of social development,and human rights have been attached great importance to in public policy.Thirdly,the mechanism has transformed from the "correspondence theory of truth" to the "consensus theory of truth".The decision-making authority delivered the reform plans to the public for the "uncertain" dialogue and consultation,and balanced the multiple and complex interests,thus has formed the inclusive consensus,value standard and policy orientation on the basis of diversity and dialogue.Fourthly,an open policy center has been established in the government,which no longer plays the traditional role of deciding direction,but does more on leading the public appeal.Thus the public appeal can work around this policy center and form a two-way interaction,and show the important democratization power of China’s public policy.Although there are still some matters to be resolved,it is certain that it has become a key support to the multiple harmonious order and a new force promoting the development of democracy and the rule of law.