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卫生服务事关人的生命和健康,在当今世界，卫生政策是各国社会政府的主要领域，是政治争议的核心和焦点问题之一。作为一项主要的社会政策，卫生政策最基本的目标是维护和促进公众的健康，确保公众在需要的时候能够及时得到适当的卫生服务。种种迹象表明，中国卫生治理体系面临的外部压力以及该体系内部的结构性紧张日趋严峻⑤，国家卫生治理能力偏弱⑥，全面深化改革已经是势在必行。

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本章将引入卫生绩效理论、政策试验理论、国家治理理论，并试图为后续的案例分析引入理论叙述与分析框架，通过理论的整合与分析框架的构建，搭建一个能够被人接受的、简单的、合乎逻辑的分析平台。治理是各种公共或私人的个人和机构管理其共同事务的诸多方式的总和,医改从政府或市场的二元选择逐步走向治理观，意味着条件、行动者等要素的调整，在实践和理论上有政策试验的产生的基础。

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目前，中华人民共和国卫生政策变迁的研究主要局限在政策的梳理和事实的罗列， 缺乏从政策试验角度进行历史经验分析。本章运用政策试验视角，探讨１９７８ 年至今中国卫生政策试验的变迁过程和运作机制。改革开放以来，中国决策者不断地采用试验的方式寻求合适的卫生治理体系和提升卫生治理能力。

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任何改革最核心的问题就是利益结构的调整。因此，公立医院综合改革整个过程应始终把处理好各方利益摆在首位， 这也是卫生治理所要达到的目标。卫生政策理念就是把卫生服务作为公共事务本身价值取向。三明试点就是要围绕“百姓可接受、财政可承担、医院发展可持续、医务人员受鼓舞” 的卫生治理目标， 解决好政府、公众、医院和医务人员等各方利益.

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中国的实践告诉我们，为了解答“从哪里来， 到哪里去”这两个问题，寻找合适的治理之道，中国的卫生政策试验改善卫生治理的作用机制有两个比较明显的阶段，并从原来的单纯选择逐步转型到整合为主的作用机制。伴随着经济自由化、一体化的进程，越来越多的各种形式国际合作组国织跨越国家、地区、边界发挥着重要作用，国家弱化是世界政治发展大势所趋。卫生政策试验的内涵是丰富多彩的，涵盖卫生政策的价值理念、目标、政策工具及其设定，乃至政府的卫生政策制定过程。这是一个不断试错的过程， 也是个连续、渐进的政策学习过程。

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