機關報中的部門分歧：中國大陸醫療保險並軌觀察

本文檢視中國大陸的醫保並軌政策，以機關報中的報導內容為主，分析人社與衛生系統之間的分歧。我們發現，在國務院確定整合三大醫保體系，即職工醫保、居民醫保、新農合後，雖然二大系統均支持並軌，但對於醫保應並軌於哪一部門，卻相當分歧。二大系統均提出有利於己的論述，反映在各自主管的機關報裡。透過交叉分析，我們發現，《中國勞動保障報》強調醫療體制管辦不分；《健康報》則認為醫保應與其他層面的醫改結合。同時，透過分析《人民日報》，我們發現，中共中央尚未對醫保並軌於哪一部門做出決定。在可見的將來，二系統的爭論仍將持續。

關鍵字

醫保；機關報；部門利益；人社部；衛計委

並列摘要

This paper conducts content analysis on three ministry newspapers to explore the bureaucratic politics behind China's integration of its health insurance schemes. In 2013, the State Council issued the Notice of Dividing the Tasks for Implementation of the Plan for Institutional Reform and Functional Transformation. In this Notice, the government decided to integrate three major health insurance schemes: an urban employee basic insurance, an urban resident basic insurance, and a new rural cooperative insurance. However, the process was delayed due to the competition for supervision of the integrated system between the Ministry of Human Resources and Social Security (MHRSS) and the National Health and Family Planning Commission (NHFPC). The two Ministries elaborate their justifications through their official newspapers. Our analysis indicates a significant difference across these newspapers in presenting the reasons for integrating the schemes under either the MHRSS's or the NHFPC's supervision. Through examining the reports in the People's Daily, we also find that the top decision-makers have not come to a conclusion as to which Ministry should supervise the integrated system.