从“大健康部”构想看医改的战略升级

建立一个集卫生、医疗保障等多种相近职能于一身的国家健康福利部或国家健康委员会,是一种典型的＂大部门体制＂改革思路。2008年国务院机构改革时,成立了工信部、交通部、人社部、环保部等几个＂大部门＂,体现了＂探索大部门体制,健全部门间协调配合机制＂的改革方向。此次＂大部制＂改革没有涉及卫生、医疗保障等部门,也没有与新一轮医改联系起来。

韩国国民健康保险

未满6岁的儿童在疗养机构住院,由健康保险全额负担;门诊治疗时,仅需交纳成人费用的70%。韩国的全民医疗保障系统分为国民健康保险和医疗给付事业。两者基本覆盖了全体国民,2007年年末,国民健康保险制度覆盖韩国96.3%国民,其余3.7%以基础生活保障对象等形式编入医疗给付事业制度。尽管医疗给付事业和国民健康保险对象不同,但两者均由健康福利部、国家健康保险公司和健康保险审核评价机构运营和管理。

“大部制”为何每次都被强烈关注

8月17日,在2012中国卫生论坛上发布的《＂健康中国2020＂战略研究报告》提出：涉及人民健康的若干职能相近的部门,如卫生、医疗保障、计划生育、环境保护、体育运动等部门,可以考虑逐步合并,建立国家健康福利部或国家健康委员会。

Problems of elderly health care and welfare arrangement --Case study of demand on elder care in northeastern of Thailand

This research attempted to explain the problems of elderly health care, the problems and suggestion in elder welfare arrangement and the demand on elder care. The survey underlying this study was conducted in Muang district, Khon Kaen province, Thailand. Eighteen subdistricts were interviewed in the study area. Data were collected in two areas of Khon Kaen province, that are, the city of Khon Kaen and the outside Thesaban Nakhon Khon Kaen. The random sample consisted of 386 elders： 112 elders lived in the city of Khon Kaen and 234 elders lived outside Thesaban Nakhon Khon Kaen, Muang district, Khon Kaen. The analysis of the demand on elderly welfare gave an interesting result that the elders demanded on monthly income to support living cost and medical services at high level; The demand on housing was at low level; The demand on education, religion and culture the demand on club, sport and entertainment, and the demand on job and art were at the moderate level; The main problem of elderly welfare arrangement was the scarcity of budget support, the weakness of elder health, and activities announcement. The analysis of pattern of elder welfare： The case study of elder care identified that 31.87 percent of the elders had demand on elder care. Price of the elder care at 100 Baht per day was mostly selected about one-fourth of all the case occurred. Female elder selected the elder care at 100 Baht per day, while male elder choose at a higher price level, which were 200 Baht per day and 150 Baht per day respectively. The female elder care was the most popular. The elder care age between 30-39 years was mostly selected. Finally, most of elders purposed the working day of the elder care depend on their appointment.

2010年美国爱达荷州一例溃疡棒状杆菌引起的呼吸道白喉样疾病

2010年9月12日，爱达荷州健康福利部收到一例呼吸道白喉样疾病的报告，病例为80岁男性，咽拭子样本中有溃疡棒状杆菌。尽管溃疡棒状杆菌具有人畜共患性，但报告的患者未接触动物和服用未灭菌的奶制品。其免疫史不详。溃疡棒状杆菌引起的呼吸道白喉样疾病不常见，但在呼吸道白喉罕见的发达国家已有报道。最近一次报告的病例是在2005年。