RÉSUMÉ
Policy tools are ways to quantitative analysis of policy text content and the construction of a "Policy Tools-Policy Objectives (X-Y Dimension)" framework to explore long-term stability and late-stage innovation of policy development. This paper reviewed the development process of medical and health policies since the founding of the People’s Republic of China, and divided 1949-2021 into four stages of reform breeding, institutional transformation, reform improvement and continuous deepening. Screening 121 medical and health policy texts issued at the national level since the founding of the People’s Republic of China, quantitatively analyzing 5 957 policy text cells from the perspective of policy tools, counting the use of policy tools in various periods, and excavating the inherent logic of policy texts, policy tools and policy objectives to derive development characteristics of internal logic deduction. The development of China’s medical and health policy in the new period will serve the people’s health in the first place, adhere to the development direction of equalization of basic public service, strengthen the coordinated development of scientific and technological innovation and talent training, build a health and healthy development system with Chinese characteristics.
RÉSUMÉ
Policy tools are ways to quantitative analysis of policy text content and the construction of a "Policy Tools-Policy Objectives (X-Y Dimension)" framework to explore long-term stability and late-stage innovation of policy development. This paper reviewed the development process of medical and health policies since the founding of the People’s Republic of China, and divided 1949-2021 into four stages of reform breeding, institutional transformation, reform improvement and continuous deepening. Screening 121 medical and health policy texts issued at the national level since the founding of the People’s Republic of China, quantitatively analyzing 5 957 policy text cells from the perspective of policy tools, counting the use of policy tools in various periods, and excavating the inherent logic of policy texts, policy tools and policy objectives to derive development characteristics of internal logic deduction. The development of China’s medical and health policy in the new period will serve the people’s health in the first place, adhere to the development direction of equalization of basic public service, strengthen the coordinated development of scientific and technological innovation and talent training, build a health and healthy development system with Chinese characteristics.
RÉSUMÉ
Based on the advocacy coalition framework,the game between policy alliances with different beliefs is regarded as a key factor contributing to the long-term policy changes. At the same time, the policy changes are seen as the product of the antagonism of the core faith of the alliance, the policy-oriented learning and the internal and external shocks of the coalitions. The change of China's health care policy has always been accompanied by the debate on whether fairness or efficiency should be given priority between"government-led"and"market-oriented"coalitions. Its evolving characteristics are consistent with the explanatory logic of the advocacy coalition framework. Based on the advocacy coalition framework this paper makes a comprehensive of review of the historical literature on Chinese medical and health policy,it founds out that advocacy coalitions with different beliefs are critical to the re-form and return of the health care policy, policy-oriented learning promotes the gradual change of the policy, while internal and external shocks provide opportunities for policy paradigm change. Besides,the more passive and lack of active initiatives of policy change,the government's bias of the public welfare feature of the medical business coupled with the underdevelopment of market economy are the main causes for lagging medical policy and frequent industry chaos. To this end,it is recommended to highlight the forward-looking policy,strengthen the internal drive,create a more liberal debate environment for the coalitions,promote the learning of policy orientation among coalitions to en-hance the scientific and effective medical and health policy change.