我国医疗保障制度转型研究

A Study on the Transformation of China's Social Healthcare System

虽然我国基本实现了全民医保,但是制度上存在三维分立、重复参保、衔接不畅等问题,医疗卫生服务中存在的城乡差异、地区差异、人群差异等非公平性问题,基金面临人口老龄化和持续待遇提升带来的潜在风险问题等,使我国医疗保障亟需进一步的转型发展。转型的方向是:构建城乡统筹、制度和管理统一、信息向上集中、服务向下传递、科学筹资和公平的医疗保障系统。同时促进"医卫"、"医药"、"医保"合理分离,重塑信任和理性的医患关系,从根本上解决"看病难"、"看病贵"的问题。

Although China has basically achieved universal health care, but on the institutional level, there still exists the problems of three-dimensional separation, repeated participation, and ill connection between plans. In terms of medical and health services, there are also unequality issues such as the disparities between rural and urban regions, regional differences, and differences among population groups. The heath care fund is facing with more and more potential challenges due to population aging and constantly rising benefit levels. Due to all these problems, it is imminent for the social healthcare sustem to be transformed. The direction for transformation is to coordinate the urban and rural plans, unify systems and management methods, centralize information upwards, transfer services downwards, and establish a scientific and equitable heahhcare financing system. Meanwhile, we should promote the separation of ＂medical and public health＂ ,＂ medicine＂ ,＂ social heahhcare system＂ so as to rebuild the trust be- tween doctors and patients and root out the problems of ＂difficulty to seek medical services＂ and ＂unaffordability of medical services and medicines＂