<International circulation>:  China is similar to the United States in that regard.  Although there are far-reaching declarations made at the national level most implementation is at the local level and varies significantly depending on the specific location and environmental situation.  Two problems with this setup are; firstly， it is difficult to convince local administrative bodies to spend lots of money to get information like this.  Secondly， China has a tendency to maintain a national persona and desire to show unity as a nation due to the worry about division domestically.  As such there is a motivation to analyze statistics from a national rather than local perspective.  How do you deal with this?

    《国际循环》：这样看的话中国的情况和美国很相似。尽管是国家制定影响深远的政策，但是实施这些政策的还是地方政府，并且在特别的地区和环境下情况变化很大。这种体制的两个问题是：第一，很难确定地方行政区主体是否花费了大量的金钱来得到所需的信息。第二，中国倾向于维持一种国家性身份并且由于担心国内分裂而希望显示出国家的整体性。在存在这种动机的情况下，常常会从全国的角度而不是从地区的角度进行分析统计。您认为该怎样处理这样的情况呢？
 
    Prof. Goff:  There are two ways; first is that it is possible to design sampling strategies in which you oversample in certain local areas that are ready to make change and ready to consider change.  A surveillance system can be developed such that it provides national estimates but simultaneously enables local areas， counties or cities， to decide whether to consider change on a specific area.  By oversampling within the context of the national survey on a particular issue local areas are willing to consider change and willing to implement a policy.  It is possible to do that in such a way that different communities that are interested in making changes on different topics can supplement data collection in areas they are most interested in， then evaluate the impact of a policy that they develop and implement.  It is certainly doable.  Is it expensive?  One could argue that it is.  I would add that， with the example of the United States， it is estimated that cardiovascular disease costs the US economy approximately 500 million dollars each year.  When people say that we cannot afford to do the surveillance that we need， I would say that we cannot afford to not know what we are doing or whether it is working.  We are spending half a trillion dollars， that is the combined direct and indirect costs to the economy， in economic impact of cardiovascular disease.  We simply cannot afford not to know what we are doing and whether it is working.

    Prof. Goff: 解决这种问题的办法有两个；第一个是，设计抽样调查策略，在准备进行改革和准备考虑改革的特定区域进行过量采样。可以建立一种监督机制来提供全国的评估，而且同时还能在局部地区、城市或县区进行评估，从而决定是否在那些特定的区域考虑改革。通过在对特定问题的全国调查范围内进行过量采样，局部地区就能考虑改革和履行一项政策的实施。还有一种可能的方法是对不同的问题做出改变感兴趣的不同社区能够帮助补充收集他们最感兴趣地区的资料，并且最后他们还能对那些自己制定和实施的政策的效果进行评估。这些方法必定是可行的。那么这些方法是否开销很大呢？有人可能会这样问。我还想声明的是，以美国为例，据估计每年心血管疾病花费的美国财政收入大约是5亿美元。当人们说我们负担不起我们需要的监督体制所需的花费时，我想说的是我们负担不起的是不知道我们在做什么或是否我们所做的事情是有效的。我们正在心血管疾病对经济的影响上花费5千亿美元，这是直接和间接经济费用的总和。我们只是负担不起我们用这些钱干了什么以及我们的行动是否收到了预期的效果。

上一页  [1]  [2]  [3]  [4]