روش های کاهش تصدی گری دولت در مدل های اصلاح ساختار حوزه سلامت ، تجربه سایر کشور ها: با تاکید بر سیاست های کلی اصل 44 قانون اساسی

پس از ابلاغ سیاست های کلی اصل 44 قانون اساسی در سال های 1384 و 1385؛ « قانون اجرای سیاست های کلی اصل 44 قانون اساسی» نیز در سال 1387 تصویب و ابلاغ شد . برای تطبیق حوزۀ سلامت با سیاست های کلی ؛  در تبصره 2 جزء ج ماده 3 قانون مذکور ، واگذاری فعالیت ها و هر گونه توسعه  حوزه سلامت،موکول به تهیۀ لایحه ای ظرف یکسال از تاریخ تصویب قانون اعلام شد . این اقدام به مدت پانزده سال به تاخیر افتاد . ضمن اینکه در سیاست های کلی مذکور استثنائی قید نشده بود . بدیهی است شناسایی دلایل این تاخیر در مورد تشکیلاتی که گسترده ترین تشکیلات دولتی محسوب می شود، ضروری است . در کنار این امر شناسایی سیاست گذاری بخشی و نحوه اجرا در مدل های سایر کشورها می تواند در ترسیم چشم انداز کمک شایانی باشد . برنامۀ اصلاح ساختار حوزه سلامت کشورها با هدف «کاهش تصدی گری دولت » عمدتاً از سه دهه قبل آغاز شده است . سیاستی پیچیده ولی اجتناب ناپذیر که کشورها را وادار به بررسی روش های متنوع و بازمهندسی برنامه های اجرا برای دستیابی به این هدف نموده است . هدف از این تحقیق شناسایی روش های کاهش تصدی گری دولت ،  در مدلهای اصلاح ساختار سایر کشورها،  برای اجرای  سیاست های کلی اصل 44 قانون اساسی در حوزه سلامت کشورمان  است .

the methods of reducing government tenure in the models of reforming the structure of the health sector, the experience of other countries: emphasizing the general policies of article 44 of the constitution

after approval  of the general policies of article 44 of the constitution in 2005 and 2006; the law on the implementation of general policies of said  articel of the constitution was approved and promulgated in 2008 to adapt the health field to the aforementioned general policies; in note 2, part c, article 3 of the aforementioned law, it was announced that the assignment of activities and any development in the health sector is deferred to the preparation of a bill within one year from the date of approval of the law. the above matter has been delayed for fifteen years. while there are no exceptions mentioned in the general policies, it is obvious that it is necessary to identify the reasons for this delay in the case of organizations that are considered the most extensive government organizations. in addition to this, identifying sectoral policies and how to implement them in the models of other countries can be helpful in drawing the perspective the program of reforming the structure of the country’s health sector with the aim of &reducing government tenure& has been started mainly since three decades ago. a complex but inevitable policy that has forced countries to examine various methods and reengineer implementation plans to achieve this goal. the purpose of this research is to identify the methods of reducing government tenure in the structural reform models of other countries, in order to implement the general policies of article 44 of the constitution in the field of health in our country.similarities have been observed in the methods used to reduce the government’s tenure in the field of health, but there is no fixed prescription in this field for countries. the results of this research show that the adopted policies include decentralization, reduction of tenure (privatization), development of the private sector and encouraging people to benefit from private services. there are more than 33 methods of reducing tenure in the field of health, and according to the current laws of the country, it is possible to use at least 10 of them, of which only three methods are currently used. also, in some countries, there are various types of public/private partnerships have been used.