Necessary intension that clarifies the whole people's medical insurance

Necessary intension that clarifies the whole people's medical insurance
Necessary intension that clarifies the whole people's medical insurance
The thunder tide deepens the promotion of the system reform work of the medical and health with our country, " the whole people's medical insurance " Has already become the topic discussed warmly, all kinds of medias and meetings are the words intensifying the whole people's medical insurance constantly even more. Analyze, stand up, will find people to the intersection of the whole people and although with one voice understanding of medical insurance, but the melody is different. So, necessary intension and evaluation criterion to clarify the whole people's medical insurance. The origin of the whole people's medical insurance and abundant the whole people's medical insurance of intension come from Universalcoverageforhealth of English. All residents whose its intension refers to an country or area enjoy sufficient and equal system, hygiene service and economic risk,etc. guarantee that melt in health. Understand this meaning can't be only from ensuring the angle of system or economic allocation of risks of disease to consider, must also be from fairness of the service system supplier of the health care, accessibility and accountability (Responsiveness) When investigating together. The intersection of the whole people and translation of medical insurance and English original meaning neither totally correspond to, nor very accurate actually. This is because translation this it loses health and unity original meanings includes to be equal to take two the intersection of and artistic conception of treatment already, have only emphasized the guarantee of medical care, has ignored the health to ensure, and not reflected the basic requirement unifying equal treatment of melting for people, only " Everyone is equal in front of the health right " . The statement of the medical insurance of the whole people of our country and medical guarantee system in urban and rural areas of the fast development in recent years have greater relations. Since the 1998, our country especially the risk was started with in hospital progressively from control demanding party see the doctor, seek medical advice economic risk, establish urban worker's basic medical insurance system, new rural cooperation medical treatment systems, systems and urban residents basic medical insurance systems of medical rescue in urban and rural areas, the commercial health insurance has got the fast development too. Up to the end of 2010, our country's multiple basic medical treatment ensure the system to already cover 1,260 million urban and rural residents. Someone thinks, realized the whole people's medical insurance when multiple medical treatment ensured the system to cover the whole people, this kind of view is inaccurate, the essence of the whole people's medical insurance of twisting, it can only be the first step taken to the whole people's medical insurance at most. Usually the standard of appraising the whole people's medical insurance, weigh a country or regional the intensity of the whole people's medical insurance needs to investigate five situations of linking degree at the same time. These five respects complement each other, close and related, form the investigation content of the whole people's medical insurance process of appraising a country or regional together, have realistic practicality and great guidance. First, cover the crowd's quantity. That is to say for what a crowd of large quantity to offer the system, hygiene service and economic risk guarantee. Usually can use, ensure population that system cover account for the whole proportion of population, come on measurement. Second, the content ensured. According to ensuring the content in macroscopic, can investigate whether to cover fields such as medical treatment, preventing, keeping healthy, recovering and medicines,etc.; Say, can investigate how many service items every above-mentioned field is covered with from ensuring the project. Under different means of payment, can investigate, pay or pay how many service items does it cover with under the situation according to number of people according to project, how much number,etc. paying according to number covers. Third, the level ensured. How high this refers to ensuring the compensation level of the system! Can investigate whether ensuring the system sets up expense sharing system and intensity size, such as get up in one pair of lines, bind line and individual to bear proportion and actual compensation proportion etc.. Under replenishing the supplier's hygiene system, can investigate the paying price to serving remedying the intensity of the whole cost; The proportion of remedying the cost is the higher to charge, the less subsidy share of the government is, the lower the public service intensity of the service is, it is corresponding and low to ensure competence too. Fourth, the level of allocation of risks. It is difficult to foresee that the risk of disease takes place to the individual, but is shown as probability incident on the colony, it is all right overall assurance. Improve the stability, sustainability and ability to resist risk of ensuring the system, must share the intersection of disease and risk at as old as possible group. This needs to raise and ensuring using the level in a unified manner of fund, can move forward progressively according to the level of county, market, province, the whole country. Inside a country, can make sure the use of funds of the national pool is most ideal state and development goal. Under replenishing the supplier's hygiene system, the level of allocation of risks is realized by different level centralization of state power and fraction of governments. Unify the policy, decentralized management contributes to unifying residents' guarantee treatment, raise local government's accountability healthy to residents and efficiency of management. The fifth, the unity of the system. The whole people medical insurance require hygiene serve and ensure treatment to be equal to take, this must advance various medical treatment ensure integration of system and unify progressively. Theoretically, the fair intensity of the single guarantee system is the best. Has realized route and experience of the whole people's medical insurance for over 100 years, the human society has already tried to find out and created two kinds of fairer and effectiver hygiene systems, one kind is the social health insurance system which Germany created and practised (Socialhealthinsurance of latter stage of the 19th century, abbreviated as SHI) ,Another kind of will it be early years the 20th century the former Soviet Union initiate and Britain carry forward the national hygiene of Ever Bright serve the system (Nationalhealthservices, abbreviated as NHS) . These two kinds of hygiene systems are generally thought it is the effective system choice of realizing the whole people's medical insurance by the international community. Though human civilization develop commercial the intersection of health insurance and system too, only his foundation as national hygiene system extremely specific country, because its fair and efficiency has all met the great challenge, the performance of the hygiene system is not fine. According to studying, 140 countries adopt the hygiene system of NHS to realize the whole people's medical insurance at least in the whole world, exceed implement social the intersection of health insurance and the intersection of system and quantity of country obviously, important fact this our country and other developing countries draw lessons from. NHS system most apparent characteristic the whole people ' But not patient) Bear the construction, operation and management funds of the service system of the public health care, the government bears service provider of the health care, owner and duty of the persons who supervise, the whole people enjoy the equal service treatment that take, fairness, expense that the hygiene serve control result and health to produce efficiency better. Our country realizes the whole people's medical insurance needs time according to actual conditions of our country at present, we have put forward and built the basic health care system, realized everybody's grand goal of enjoying basic health care service in 2020 years. On the action tactics, insist that " protects the basic, strong basic unit, builds the mechanism " Principle,promote medical treatment, public health, medical treatment ensuring and medicines supply ensuring system constructions four major, did a good job of five focal points recently, the reform effect over the past two years was obvious. But ,It still needs to make extremely hard and bitter efforts to realize the goal of the whole people's medical insurance. This is because according to ensuring the system in medical treatment facing demanding party, first, the system of all kinds of guarantee covered population though has already exceeded 90% at present, but ensure the range to be still relatively limited, is still in from the expansion period ensuring ensuring to the clinic in hospital. Second, still the service item which some residents need fails to enter and compensate the range, to wipe out range to be narrow policies and regulations. Third, compensate the low intensity, it is relatively heavy to effect an insurance, join and shut resident's personal burden. Fourth, the urban medical insurance, with shutting funds to conduct the level newly and agriculturally low, mainly with the county (district) It is a unit with the districts and cities, need longer time to carry out the transition to the provincial and national pool. Fifth, basic medical treatment ensures the system not to be unified, raise funds between the systems horizontal disparity is great, the medical treatment difference is great. The medical treatment of urban and urual areas of whole country ensures system reunification to need longer time to finish too. If from supplier investigates our country realizes the process of the whole people's medical insurance allows of no optimist. First, public medical organization, especially two, tertiary hospitals are public beneficial and non- strong, even have more strongly trending towards favourable motive force. Second, the subsidy policy to the public hospital of governments at all levels is not implemented, it is not enough to compensate efforts, staff member funds subsidize issue, reach common understanding yet, depend on, face patient, charge main source in the personal income still. Third, public hospital rely on with medicine mending, curing mechanisming, service charge to to remedy function to be too better cost still, fail to position it at and control patient's excessively medical demand means. Fourth, the relation between the public hospitals emphasizes the interests competition excessively, ignore cooperation and complementary relation, the integrality, cooperativity, continuity of service system are also not good. Fifth, can not set up the complete system of changing the place of examination, health " goalkeeper " of the medical health organ of basic unit in urban and rural areas Function, still less than being given full play to far.


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