三年磨一剑 一剑舞三年——新医改制度设计凸显“中国特色” Three years mill rocks sword dance three years-new medical system design highlights“Chinese characteristics”

    新华社北京８月３日电(新华社记者) 三年回眸，新医改取得的阶段性成功离不开科学的顶层设计和制度创新。从最初决策、基本框架的确定到具体实施中的不断完善，医改三年是一个科学决策、不断创新的过程，也是一个充分尊重民意、吸纳民智、发扬民主的过程。

    Beijing, aug. 3(The xinhua news agency) Three years in，The cure of the new stage success without science has the top design and system innovation。From the original decision、The determination of the basic framework of the concrete implementation to continuous improvement，Cure of the three years is a scientific decisions、Constant innovation process，Also a full respect for public opinion、Absorb intelligence、The process of democracy。

 

    新医改方案“三年磨一剑”    New medical scheme“Three years mill rocks”

    从调研、起草到最终出台，新医改方案经历了三年的酝酿期。

    Research from the、Draft to finally come，New medical scheme for three years experience of YunNiangQi。

    卫生部办公厅主任侯岩对记者说，新医改方案从最初酝酿到定稿通过，经历了一次政治局集体学习、三次国务院常务会、一次政治局常委会。“可以说，新医改方案基本理念、基本原则、基本路径的确定，是在党中央、国务院的直接领导下完成的。”

    Health chief of staff, HouYan told reporters，New medical scheme from the brewing to finalized through，Through a collective learning politburo、Three times ChangWuHui under the state council、A politburo standing committee。“Can say，New medical scheme basic ideas、Basic principles、The determination of the basic path，Is the central committee of the、Under the leadership of the state council directly to complete。”

    自２００６年７月起，卫生、财政、社保、药监四部门就医改重点和难点开展专题调研。随后，国务院又分别向各省区市，各阶层、各行业和社会群体广泛征求意见。“座谈会开了不计其数，其中由国务院领导亲自主持的座谈会就开了五六次。”侯岩说。

    Since July 2006，health、financial、Social security、Four department also cure of the key and difficult carry out special investigation。then，The state council and to the provincial respectively，strata、Various industries and social group asked for a wide range of opinion。“Symposium opened countless，Among them the leadership of the state council hosted by himself symposium opened the five or six times。”HouYan said。

    新医改方案还首次“借助外脑”，引入境外商业咨询机构参与政策设计。受国家发展改革委委托，世界银行、麦肯锡咨询公司、北京大学、复旦大学等９家境内外机构参与了对新医改方案进行独立平行研究。

    New medical plan also for the first time“With outside brain”，Introducing foreign business consulting institutions involved in policy design。Entrusted by the national development and reform commission，The world bank、McKinsey, a management consultancy、Beijing university、Fudan university and internal and external agencies involved in the family of cure of the new scheme of independent parallel study。

    充分尊重民意、吸取民智是新医改制度设计的最大亮点。

    Fully respect the opinion、Drain intelligence is the new medical system design of the biggest highlights。

    国家医改办组织力量编写了《深化医药卫生体制改革问答》，还专门编印出版了《医改与我》的小画册，通过４０个简明扼要的问题设计，加上通俗易懂的配图，向普通群众宣传介绍新医改。

    Cure of the state to organize forces to write《Deepen the reform of the medical care system in question and answer session》，Also special publication)《Cure and I》Little picture album，Through the 40 brief and to the design problem，Plus straightaway pictures，To the general public information about new medical。

    此后，社会各界邮件、传真、信件如雪片般飞来。最后，国家医改办收到的意见建议多达３５９２９件。根据这些建议，草案最终进行了１９０余处较大修改。

    Since then，The social from all walks of life mail、fax、Letters poured in such as a fly。finally，Cure of the state of the comments received advice for as many as 35929。According to these Suggestions，The draft final in more than 190 major revision。

    基层制度创新“一剑舞三年”     Grassroots system innovation“Sword dance three years”

    如果说新医改在顶层设计是“三年磨一剑”的话，那么来自基层的制度创新就是“一剑舞三年”。

    If the new cure of the top design is in“Three years mill rocks”words，So the system innovation is from“Sword dance three years”。

    国家医改办主任孙志刚说，新医改在制度设计上，十分重视地方的首创精神。各地在改革中也涌现了大量的典型经验和做法，一些地方基层医疗卫生机构综合改革、医保支付方式改革等实践创新均得到认真总结并在全国推广。许多配套文件的形成，也来源于基层的试点和实践。

    Medical director of the national SunZhiGang do said，The new system design in the cure，Attach great importance to the local initiatives。In the reform of all appeared a large number of typical experience and practice，Some of the local medical and health institutions comprehensive reform、Medical insurance payment reform practice innovation are summing up and get in the national promotion。Many supporting documents formation，Also comes from the pilot and practice。

    安徽省在国内最先取消基层医疗机构药品加成，实施零差价；为保证这一目标落到实处，安徽设计一系列的配套政策，如基层医疗机构公益性保障制度、规范化的药品招标采购制度、竞争性的用人制度等等。

    Anhui province in the very first cancel basic-level medical institutions drug addition，Implement zero price difference；To ensure this goal into effect，Anhui design a series of form a complete set of policy，Medical institutions such as the public security system、Standardization of the drug for bidding system、Competitive employment system and so on。

    作为一个人口大省、财政穷省，安徽并不具备改革优势，但安徽省能够率先在取消药品加成和零差价方面取得突破，对于新医改的全盘推进具有重要意义。

    As a populous provinces、Financial poor provinces，Anhui does not have the advantage of reform，But to take the lead in anhui province in cancel drug bonus and zero price difference breakthrough，For all of new medical advance to have the important meaning。

    类似“安徽模式”制度创新在三年医改过程中比比皆是。如陕西的“神木模式”、江苏的“镇江模式”、湖南的“桑植模式”“蓝山模式”等等。

    similar“Anhui mode”System innovation in three years in the process of cure can be found everywhere。If the shaanxi“Shenmu mode”、jiangsu“Zhenjiang mode”、hunan“SangZhi mode”“Blueridge mode”, etc。

    特别值得一提的是陕西的“子长模式”。陕西省子长县公立医院改变“以药养医”后，患者负担下降，医务人员积极性提高。子长的经验为“十二五”全面破除“以药养医”机制提供了一个很好的样本。

    In particular the shaanxi“Smaller mode”。ZiChangXian shaanxi province public hospital change“To raise the medical medicine”after，Patients burden down，Medical personnel improve enthusiasm。The experience is smaller“1025”Comprehensive break“To raise the medical medicine”Mechanism provides a good sample。

    “我们在北京研究时觉得这个问题很复杂，很难决断，是地方的探索给我们开拓了思路。”卫生部党组书记张茅说。

    “In Beijing we feel this problem is the complex，Hard to determination，Is the place to develop the exploration of ideas。”Health BuDangZu secretary of said。

    “在自上而下搞好顶层设计的同时，注重自下而上的路径探索，是这一轮医改在制度设计上的显著特色。”北京大学中国经济研究中心副主任李玲认为，正是这种中央与地方之间的良性互动，不断丰富着医改新政实施路径，为新医改注入了创新活力，使医改更具可操作性。

    “Do well in top-down top design at the same time，Pay attention to the path of bottom-up exploration，Is this round in system design of the cure of the significant characteristic。”Beijing university, deputy director of the China center for economic research who think，It is this the central and local benign interaction between，Enrich the cure of the New Deal implementation，For new into the medical innovation vigor，Make more operational cure。

    强大执行力凸显“中国模式”独特优势     Strong execution highlight“China model”Unique advantages

    作为一项关系到１３亿人民健康福祉的重大公共政策，三年新医改的顺利推进，背后还体现“中国模式”的强大执行力。

    As a concern to 1.3 billion people's health welfare major public policy，Three years of new medical progressing smoothly，What is also behind“China model”Strong executive power。

    党中央、国务院明确提出新医改的基本理念、基本原则和基本路径，进而统一思想、摒除杂音，为新医改的顺利推进奠定了基础。

    The party central committee、The state council put forward the basic idea of cure of the new、The basic principles and basic path，And unified thought、Eliminates the noise，For the new medical progressing smoothly to lay the foundation。

    在组织保障方面，新医改在中央层面由国家发展改革委牵头、国务院直接领导，成立了国家医改办公室，组成专门机构，抽调精干人员；在地方层面各级都有专门的机构来综合协调体制改革工作。

    In the organizational safeguard，New in the central level by the cure of the national development and reform commission lead、Direct leadership under the state council，The cure of the state office was established，Composition specialized agencies，Drafted a skeleton crew；In the local level is at all levels have the special agencies to comprehensive coordination system reform。

    此外，新医改的实施运行突破了以往卫生部门单打独斗和政府独立决策的既定改革模式，从而整合了行政和社会的力量，提高了医改工作的执行力和效率。

    In addition，The operation of the new medical breakthrough the previous department of health and the government of independent decision making it established reform mode，To integrate the administrative and social power，Improve the execution and medical work efficiency。

    新医改在推行过程中还特别注重对干部的培训。从２００９年起，国务院召集各个省份分管医改工作的主要负责人进京就医改进行专题培训，并签订责任状。与此同时，国家医改办召开现场经验会，组织各地参观学习。这些措施一方面使地方决策者们对医改有了更深入系统的了解，另一方面也使他们感到了来自中央的强大推动力。

    In the process of implementation of new medical also paid special attention to the training of cadres。Since 2009，The state council called for every province of cure of the principal performers work is to cure of the special training，And sign ZeRenZhuang。At the same time，Cure of the state for on-site experience will be held，Organize visiting learning。These measures on one hand so that the local decision makers to cure a deeply the understanding of the system，On the other hand also makes them feel powerful force from the central。

    “与其他同步开展医改的国家相比，中国新医改的运行推进机制与众不同。一些国外同行在与我交流时，他们最佩服的就是中国医改的高效率和强大执行力。”北京大学中国经济研究中心副主任李玲说，新医改的运行机制实际上是一条具有中国特色的社会改革操作路径。三年医改的成功经验，充分证明了“中国模式”的可行性，这种模式不仅适用于医改，也将为今后其他领域的改革带来有益启示。

    “And the other in the countries medical synchronization，The operation of the new China medical advancement mechanism is different。Some foreign counterparts in a discussion with me，They admire is efficient and powerful Chinese medical execution。”Beijing university, deputy director of the China center for economic research who said，New medical operation mechanism is actually a social reform with Chinese characteristics operation path。Three years of successful experience of cure，Fully demonstrated“China model”Feasibility of，This model not only applicable to cure，Will also for future reform in other fields have a beneficial enlightenment。