The coronavirus disease (COVID-19) pandemic has tested the mettle of governments across the globe and has thrown entrenched fault lines within health systems into sharper relief. In response to the outbreak of the pandemic, governments introduced a range of measures to meet the growth in demand and bridge gaps in health systems. The objective of this paper is to understand the nature and extent of the changes in health systems triggered by the COVID-19 crisis. The paper examines changes in the role of governments in (1) sector coordination, (2) service provision, (3) financing, (4) payment, and (5) regulations. It outlines broad trends and reforms underway prior to the pandemic and highlights likely trajectories in these aspects in the future. The paper argues that while the pandemic has accelerated changes already underway before the crisis, it has made little headway in clearing the path for other or deeper health policy reforms. The reform window that COVID-19 opened has not been wide enough to overcome the entrenched path dependency and structural interests that characterize the sector.

中文翻译：

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卫生政策和 COVID-19：路径依赖性和轨迹

冠状病毒病 (COVID-19) 大流行考验了全球各国政府的勇气，并使卫生系统内根深蒂固的断层线更加突出。为应对大流行的爆发，各国政府采取了一系列措施来满足需求增长并弥合卫生系统的差距。本文的目的是了解 COVID-19 危机引发的卫生系统变化的性质和程度。本文探讨了政府在 (1) 部门协调、(2) 服务提供、(3) 融资、(4) 支付和 (5) 监管方面的角色变化。它概述了大流行之前正在进行的广泛趋势和改革，并强调了未来这些方面的可能轨迹。该论文认为，尽管大流行加速了危机前已经发生的变化，它在为其他或更深入的卫生政策改革扫清道路方面进展甚微。COVID-19 打开的改革窗口还不够宽，无法克服该行业根深蒂固的路径依赖和结构性利益。