| ObjectiveSince the foundation of the People's Central Government in 1949, the Chinese Communist Party has attained political power and the new Government has, starting from the People's Democratic Dictationship and considering the actual social and economical development level and the health demands of the people, established and implemented a series of health work guidelines and policies which had made tremendous contributions to the guarantee of public health, the promotion of the people's health status and the enhancement of social and economical development. The implementation of these policies and the consequent effect had once been regarded as a nonesuch model by health institutions such as the WHO and most countries.The reform and the Opening-up to the world since the 1980's have greatly speeded up the social and economical development. Higher expectations have been placed upon the medical and health work as the conception of Health evolutes: its denotation expanded and its connotation deepened. Meanwhile, as the government regulation decreases, many administrative measures, guidelines and policies which had been proved as effective now gradually lose their effectiveness and efficiency. Asthe spreading of marketization goes on, the contradiction between present implementation of health policies and people's demand for health reaches to an irreconcilably inharmonious extent, especially in the eye of the mass-media. Hence the task of establishing and implementing health strategies and medical security system which would satisfy both the mass and the mass-media looms larges.Methods:Data resouces: Document files form State Department and Ministry of Health; public annual reports and unpublished data compilations from National Statistic Bureau, ministry of health, and CIQ Bureau; Books, journals and newspaperspublished in domestic and oversea market; Materials retrieved by Internet.Methods: By qualitative and quantitative research methods, statistical data and indicators are compared, proved, and factorial analyzed; by the methods of contrast and observation, a descriptive analysis is employed on the effects before and after the implementation of health policy, and the public's response is analyzed; by historical analysis method, the effects to health financing, health care service and resource utilization, the development of health care system and the population health caused by the release and implementation of health policy is reviewed; by the method of reduction to absurdity through historic events, mistakes in health policy making and implementation are discussed; so that the similar situation can be avoided. Whilst the evaluation research is divided into several dimensions: theoretical base on policy and health care policy, about 50 years retrospective analysis on Chinese health policy, evaluation on Chinese public health system; evaluation on urban community health service system; evaluation on western rural health situation; evaluation on Chinese health protection system; and evaluation on pharmaceutical industry's effects on health care development.Results:The logical structure of this research:1. Propositions and concepts illumination. Interdisciplinary areas are circumscribed and evaluation methods and technical routes are proposed, all these are included in the Introductory Chapter.2. Literature Review—A survey which is guided by the relating theories of great thinkers both in China and abroad, and synthesizing relative scholastic and theoretical outlooks.3. Retrospective research of Chinese health policy: From the perspective of system structure, political framework, social ideology and political environment, the evaluation of Chinese health policy over 50 years since Foundation is divided into 3 stages and 6 periods.4. Part 4 centres on the features and connotations of the public health of China, while analyzing the underlying reason of the great success once achieved, aconclusion is drawn that the attributable reason is: laying emphasis on prevention and the broad countryside. At the same time a tentative theoretical basis and guarantee methods are provided for the future framework of public health.5. Part 5and 6 stresses that another successful experience of our health work derives from the infrastructure and myriad clinical groups at the basic levels, i.e. the community health service system in the cities and the tertiary medical network in the countryside, two fundamental approached to solve "the difficulty and expensiveness of seeing a doctor".6. Seeing to the Binary oppositions extant in Chinese medical and security system, states that the standpoint for health policy execution, implementation and evaluation is equity, regarding the integral state power of China, medical-security work for the low-income disadvantageous group must be ensured.7. Part 8 attaches importance on the pharmaceutical industry in so much that being one of the pillar industries, it concerns the basic demands, strategic importance, public accessibility and national safety and it has to be technology-intensive so as to obtain advantage in foreign trade. Government price-setting, affordable price levels, safety in consumption should be taken into account to satisfy the public demand.8. Based on the above results, an expatiation is made on the tropism of Chinese health policy, specifically on valua base, basic targets and health policy choices for poverty aid, direction for root health care system, and medical protection system's development and promotionConclusionsThe government should be highly efficient "small government" during the course of turning from focusing purely on economy to focusing comprehensively on society and constructing people oriented management model. Under the institutions of a "small government", based on promoting population health level and satisfying consumers (patients), Chinese health care, Chinese health policy making and implementing, and Chinese health care services should take their responsibility respectively with the principles of fairness, efficiency, stability, and sustainable development.As for the government, besides providing effective and high quality service for the public, in the field of health care, it should take 5 actions. Firstly, it needs to correct windages on the market and make up market failures. Secondly, it has to breed, regulate, and control market. Thirdly, it needs to research and make health development strategic plans. Fourthly, the government has to finance in order to improve fairness, carry out nomocracy management and administrative intervention if it is needed. At last, the government needs to organize effective health care services, especially in public health.As for the providers (health care institutions), they have to promote internal management, improve service quality, resource utility and utilizing capability, and make effective finance.As for the demanders (patients), besides the regular tax contribution, they have to be charged with social medical insurance premium or commercial medical insurance premium, and pay by the capability for the providers.Innovations1. The dissertation applied the comprehensive fairness theory, which based on institutionism, into the theoretical research on health policy evaluation.2. The dissertation systematically integrates the theories of social transform, social change, political institution, political environment, social delamination, and social values into health policy evaluation research. Following the framework, the evolution of Chinese health policy is divided into 3 phases including 6 stages.3. The dissertation brings forward that it is necessary to build legal system for health policy making and implemention (e.g., the policy making and implementing should be protected by law). The policy making and implementing are the course of concretion from law to policy. The process of policy implementing is a process that carried policy direction through specific contents. Without the effective guarantee of law, which is the prerequisite of future health policy making and implementing, health policy is hard to be implemented.
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