The Third Plenary Session of the Eighteenth Central Committee of the Party proposed，Establish a community doctors and residents' contract service relationship。This is to build a hierarchical diagnosis and treatment system，Realize orderly medical treatment，to alleviate "expensive medical treatment、Basic Engineering of the question of difficult to see "，It is also the basic project to deal with the aging of the population and the change of the disease spectrum，It is the basic engineering of healthy China，It has important strategic significance。"Family Doctor" is here? : Research on the Contract Service Relations of Doctors and Residents in Rural Community "(Zhang Kuili，China Social Science Press, November 2020)，I thought of a health guardian system。

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Healthy Guardian is different from the health goalkeeper。Health goalkeeper is the concept of a hierarchical diagnosis and treatment perspective，Related to the grassroots first consultation and two -way referral，is the basis for realizing the matching of doctors and patients。Specifically，It focuses on door guarding and leading paths，The Bet365 lotto review first contact person who enters the medical maze，Preliminary diagnosis of patients，Determine whether the patient is treated at the grassroots level or referred to the superior medical institution。Healthy Guardian is the concept of a healthy China perspective，The diagnosis and treatment function of the health gatekeeper，It also has the functions of health management; the function of disease prevention，It also has the functions of health education and popularization of healthy lifestyles。This concept attempts to cross the narrow medical field and the field of public health，Have a strong sociological atmosphere。

The concept of health governance runs through the book。First is the source governance。The health guardian system reflects the concept of "treating the disease"，Emphasize to protect health from the source。Take the rural community as an example，Including rural human settlement environment governance、Garbage treatment、Destiny sewage treatment、Governance of atmospheric pollution、Governance of groundwater source above ground、Soil pollution treatment、Food and Drug Safety Governance、Public safety treatment, etc.，It also includes the toilet revolution、Traffic safety、Construction of sports facilities、Healthy diet、Quit smoking limit wine, etc.。

Followed by comprehensive governance。Many factors bet365 Play online games above affect residents' health in different ways，Need to cooperate with relevant departments、Coordinated forces、Comprehensive governance。This transcends medical treatment、"Three Medical Links" between medical insurance and medicine，Involved in public health、Environmental Protection、Traffic、Public Security、Sports、Education and other departments，Is a magnificent system engineering。How to avoid pushing skin between the departments、Absence of offside，Is a difficult task。

Once again a community governance。"Thousands of lines above，The following needle "。Comprehensive governance of many departments must eventually land in the community，Need community grass -roots organizations、Community Social Organization、Common participation of community residents。The setting point of the construction of healthy China lies in the construction of a healthy community。Implement healthy governance in grassroots communities，Start from the community，Combining top -down from top to bottom to top，It is a idea worth exploring in healthy China。

　New contract relationship builds a harmonious doctor -patient relationship

The author combed the contractual relationship between typical national doctors and community residents in the book，Deeply analyzed the practice of contract service relationship between community doctors and residents in pilot bet365 Play online games regions in China，The root cause behind the "low signing rate" and "signing but not appointment"。On the basis of comparative analysis，Try to propose a solution to China、New contract relationship with Chinese characteristics。

The reason why it is called a new contract relationship，First manifestations as de -administrativeization，Voluntary participation by community residents，Community doctors and community residents participate together、Two -way interaction。Residents are no longer passive acceptance in the contract service relationship，Instead of initiative and participation，In the process of institutional construction, express the desire for desire through "vote by hand"，In the process of institutional practice, express its choice of freedom through "voting with your feet"。Second，This de -administrativeization is not the government to let go of it，Instead of new concepts、New way to re -supervise，Really reflect the relationship between referees and athletes。Community doctors and residents of the community are signing two parties，is athlete，The government is a referee。The new regulatory method is no longer an administrative order，but based on the concept of social governance，Both the government's leading role，There are social organizations、Common participation of community doctors and bet365 best casino games community residents。again，Under the new contract relationship，The signing behavior of community residents is transformed into "I want to sign" to "I want to sign"，So as to solve the problem of low signing rate。Once this transformation is implemented，Signing will no longer flow in form，but a real signing。This new contract relationship，Involved in prevention、Diagnosis and treatment and rehabilitation，The whole life cycle involved from birth to death，This constitutes the long -term relationship and repeated game between doctors and patients，Then to curb the moral risk of medical supply、Building a harmonious doctor -patient relationship brings hope。

　　Theoretical effectiveness needs to be tested in practice

The complexity of the rural social environment in China，The implementation of the health guardian system will face many obstacles。Scarce and structure in the number of rural doctors，It may lead to the "voting with your feet" system model design that is difficult to implement effectively;，It may be limited to its signing behavior and participating in health governance;，The application value of the theory of community sanitation consultation governance that may be restricted by the author，Its effectiveness needs further inspection of practice。

Even so，The book's innovative exploration of the "Family Doctor" system model is still valuable。The author bet365 best casino games uses a research paradigm combined with "top -down" and "bottom -up"，The matching between the design of the system design and the wishes of the residents。The author's huge difference between the author based on Western theory and the practice of Chinese community governance，Introducing the theory of community consultation governance，It is rich in the theory of primary health care，It also enriched the theory of community governance。

The book details the key steps and support systems for building the "health guardian" system model。The former mainly includes the establishment of a signing service team、Register to sign a contract、The scope and method of signing service、Signing service receivables, payment and expires, etc.; the latter includes the construction of diversified rural grassroots health service talents、The hybrid payment system focused on "first pay"、Patient -centric hygiene service vertical collaboration mechanism、Community health participation mechanism based on community empowerment。These are the implementation of the "healthy China" operation、Promote the transformation of cure cure into people's health，All have important reference value。

　(Author Unit: School of Public Management of Zhongnan University of Economics and Law)