Study On The Implementation Dilemma Of China's Off-site Medical Insurance Policy Based On The Policy Network Theory

Since the reform and opening up,with the deepening of China's health care system reform,China's medical security system has been continuously improved,and the universal medical insurance system has basically taken shape.With the strong fluidity of population,more and more people in China have to receive medical treatment in allopatry.However,in the process of getting medical treatment in different places,the legitimate medical insurance rights of the insured cannot be guaranteed,which has become to a prominent social problem.At present,localized management of the basic medical insurance system is in contradiction with the social expectation of barrier-free access to medical care in China.To solve the problem of off-site medical treatment has become one of the key livelihood issues of the Chinese government.Since 2009,a series of policy documents have been promulgated to solve the problem,such as the interim measures for the transfer and continuation of basic medical insurance,some instructions on remote treating settlement for medical insurance and the integration of urban and rural medical insurance system.The implementation of off-site medical treatment insurance policies have obtained some achievements,but the progress is slow.Why is it difficult to implement China's off-site medical insurance policy? What are the obstacles? In this regard,based on the policy network theory,this paper constructs a policy network-policy implementation analysis framework to interpret and discuss the process of China's off-site health insurance policy.This study regards the policy as a network system consisting of five different types of network subjects.They are policy community,intergovernmental network,producer network,professional network and issue network.The network environment,network structure,and network interaction are the main factors that influence the policy implementation.Through analysis,we found that there are three reasons for the ineffective implementation of off-site medical insurance policy.The obstacles in three aspects: the restriction of environmental factors such as regional economic disparities and imperfect related systems;the disequilibrium in theconfiguration of the network structure;and the benefit game among different policy networks.On this basis,three countermeasures are put forward: firstly,promoting the reform of the supporting system;secondly,optimizing the network structure of the policy;thirdly,constructing the policy network interest coordination mechanism.