健康中国背景下医疗保障制度向健康保障制度转型探索

Exploration of the transformation of medical insurance system to health security system under Healthy China

健康中国的国家战略明确要建立健康保障制度,从健康危险因素控制与保健因素促进入手保障居民健康。健康保障制度与医疗保障制度在保障目标、切入点、保障内容与补偿机制均存在差异,需要通过扩展保障的内容、医疗保险转向以健康为中心、医防教养融合等多种策略实现医疗保障制度向健康保障转型。以健康为中心的医疗保险改革需要从扩展健康内涵、支付方式改革入手,强化医疗保险对服务供给体系的约束与引导,同时这也是医疗保险发展的必然方向。

The national strategy of Healthy China clearly establishes the health insurance system,which would control health risk factors and enhance hygiene factors to safeguard the citizens' health.There are some difference in goals,forces,contents,and compensation mechanism between health insurance system and medical insurance system.The conversion from medical security system needs to take actions including of extending the security contents,health-centered medical insurance,a combination of medical treatment and endowment.Health-centered medical insurance reform needs to start with extending health contents and payments reform,enhancing the controlling and guiding the health delivery system.This is also the inevitable direction for the development of medical insurance.