和谐医疗保障制度创新研究——关于我国组建管理医疗组织的思考

A Study of the Innovation of Harmonious Medical Security System

管理医疗组织将医院、医生、患者和保险公司之间的利益统一起来,为组织内成员提供廉价、高效、高质量的医疗保障。将管理医疗组织引入我国可先行试点,然后逐渐扩大范围。建议由医疗支付方控制我国的管理医疗组织,医疗支付方的权力机构为全民社会医疗保障管理委员会;组建管理医疗组织后,在强化政府责任、加强政府监管和加大政府投入的同时,应引入竞争机制,以满足不同层次的社会医疗需求和促进医疗服务供给的竞争。

The organization of medical management unites the interest of hospital, doctor, patient and insur ance company and provides members with low-price, high-effect, high quality medical security. The introduction of the organization of medical management into our country can be done as trial at first, and then expand the coverage gradually. It is suggested that organization of medical management introduced into our country be controlled by the party offering medical payment. The authority organism of the organization of medical management is the medical security and management committee of the whole society. After the organization of medical management is formed, competitive mechanism should be introduced to satisfy the medical need of different social groups and to encourage competition among the medical service providers, while the government＇ s responsibilities are strengthened, and the government＇ s monitoring function augmented and government＇ s investment increased.