中新社北京7月11日电 题：改革起于微末 中国大医院自行“断奶”

Arriving on July 11, Beijing problem：Reform in China since lowly to hospital“weaning”

　　中新社记者 欧阳开宇

China OuYangKaiYu reporters

　　“同样的药，这个月去结账费用就要从1300元降到1100多元。”65岁的退休老人李琪坐在北京友谊医院内庭的长椅上，笑着对中新社记者比划着“差价”。

“The same medicine，This month the bill will cost from 1300 yuan to 1100 yuan。”The 65-year-old retired old man LiQi Beijing friendship hospital sitting on a bench in the main，Smile at the arriving journalists gestures“Price difference”。

　　一周前，李琪住进友谊医院时，他看到了在医院药房的电子公示牌上，滚动显示取消加成的1500余种药品的现价和原价，大厅内悬挂着“深化医改”、“取消药品加成”的大幅标语。

A week ago，LiQi live in friendship hospital，He saw in the hospital pharmacy electronic GongShiPai，Cancel the displayed bonus, more than 1500 kinds of drugs and the present price of the original price，Hanging in the hall“Cure of the deepening”、“Cancel the drug addition”Considerably the slogan。

　　当时，李琪并不清楚，他选择的医院已成为目前中国医疗卫生界最新的一块试验田。这家位于北京市主城区的医院是中国取消药品加成的第一家三甲医院。从7月1日起，像李琪这样的患者能感受到的是，这里的药价比同级别医院便宜15%。

At that time，LiQi is not clear，His choice of hospital has become China's medical WeiShengJie latest a piece of experimental plot。The city is located at the hospital is China the first a bonus cancelled drugs 3 armour hospital。From July 1,,，Like LiQi such patients can feel is the，This drug prices than with level hospital 15% less。

　　患有心脏疾病的李琪每月要服6种药，按照医院新规，除了保险，自己每月承担费用也会相应减少30多元人民币。李琪右手伸出三只手指，每月领取2000多元人民币退休金的他对此相当“重视”。

Heart disease LiQi monthly will serve 6 kinds of medicine，In accordance to the new rules，In addition to insurance，His monthly bear the costs are less 30 yuan。LiQi right hand stretched out of his fingers，The 2000 yuan monthly pension he fairly“attention”。

　　为缓解民众看病难和贵，过去3年，中国用最短的时间编织出世界最大的医保网，现在，中国医改这个被国际舆论称为“人类历史上规模最大的社会工程”碰到“最难关”——革除“以药补医”。

In order to alleviate people see a doctor difficult and expensive，The past three years，China use the shortest time to weave the world's largest medical insurance nets，now，China international public opinion is called the cure“Human history of the largest social engineering”met“The most difficulties”-removed“To fill medicine medical”。

　　在李琪的孩提时代，“以药养医”便在中国出现。20世纪50年代，官方为弥补医疗卫生事业经费不足，批准公立医院既看病又卖药。在历史上，这项政策对于保障公立医院的运行和发展曾起到积极作用。

In LiQi childhood，“To raise the medical medicine”He appeared in China。The 1950 s，Officials in order to make up for a medical and health services fund shortage，Public hospital doctor is approved and selling drugs。In the history，The policy for the protection of the public hospital operation and development has played a positive role。

　　此后，药品收入成为中国医院收入的重要组成部分，但这也在客观上导致了医院“大处方”、过度用药问题，并成为医患矛盾加剧的原因之一。鉴于革除这项旧体制已迫在眉睫，中国官方下定决心，卫生部长陈竺公开承诺，“再深的水也要趟”。

Since then，Drug income in China is an important part of hospital income，But it also led to a hospital in the objective“DaChuFang”、Excessive medication problem，And become one of the reasons the doctor-patient conflicts intensified。In view of the old system, which is imminent，Chinese officials to make up your mind，Health minister Chen subtends a public commitment，“Take another deep water also want to visit”。

　　医改是世界性难题，如全球第一大经济体美国，从老罗斯福在1912年总统竞选中首次提出全民医疗开始，直到2010年奥巴马医改法案成为法律，美国医改用了近100年。对于中国而言，破除旧体制的弊端，关键在政府、医院、医生、患者之间达成利益平衡。

Cure is a worldwide problem，As the world's first big economies in the United States，From old Roosevelt in the 1912 presidential campaign, first put forward in the medical began，Until 2010 Obama cure of the bill into law，The United States with medical for nearly 100 years。In China's case，Break the disadvantages of the old system，Key in the government、hospital、The doctor、Patients with a balance between the interests。

　　药品加成取消后，等于自行“断奶”，谁来承担这笔费用一直是中国医疗界热议的话题。在此次试点中，友谊医院前几日日均让利逾24万元人民币，预计2012年收入较上年将会出现200多万元的差额。对此，北京官员承诺，政府将给予资金支持，减轻院方忧虑。

Drug bonus cancelled，Is to“weaning”，Who will pay for the Chinese medicine is always the hot debate topics of conversation。In the pilot，Friendship hospital several days ago average daily profits to more than RMB 240000，2012 income is expected to a year there will be more than 200 yuan the balance。this，Beijing officials promised，The government will give capital support，Ease the anxiety。

　　成为医改试点后，北京友谊医院还实行医事服务费制度，门急诊大厅的引导牌上写明，普通号、副主任医师号、主任医师号、知名专家号的医事服务费分别为42元、60元、80元、100元。按医保定额报销每人次40元来算，医保患者挂普通号，个人只需支出2元，而挂知名专家号个人要支出60元。

Become a pilot medical，Beijing friendship hospital of the medical service system is，This hall YinDaoPai indicated，Ordinary number、Of doctor of vice director of number、Chief physician,、The famous ZhuanGuHao medical service charge for 42 yuan respectively、60 yuan、$80、$100。According to submit an expense account each time medical insurance quota of 40 yuan to calculate，Health care patients, hang ordinary，Only 2 yuan personal spending，And ZhuanGuHao personal spending to hang famous 60 yuan。

　　“如果单纯取消药品加成，由政府或医保补偿，不但政府、医保难以负担，医院也难实现在运营机制上的彻底转变——增设‘医事服务费’动机正在于此。”北京友谊医院院长刘建说。

“If simple drug bonus cancelled，By government or medical insurance compensation，Not only the government、Hard to afford health care，Hospitals also difficult to achieve in the operation mechanism of the radical shift-add‘Medical service charge’Motivation is in the area。”Beijing friendship hospital director LiuJian said。

　　而在经济杠杆引导下，知名专家号在友谊医院出现“罕见”剩余。患者实现分层就医，医生则感受到劳动的价值。友谊医院神经内科副主任医师陈葵说，以前患者问诊只要6元人民币诊费，“和在院门口买一个煎饼果子的钱差不多”，如今则更多地肯定了他作为医生的价值。

And in economic leverage under the guide，Famous ZhuanGuHao in friendship hospital appear“rare”surplus。Layered patients seek medical attention，The doctor is feel the value of labor。Friendship hospital nerve internal medicine of doctor of vice director of ChenKui said，Before 6 yuan patients interrogation as long as fees，“And in the courtyard the door buy a pancake fruit money about”，Today is more sure his as a doctor's value。

　　中国官方将公立医院改革视为新医改的重中之重。7月，包括友谊医院在内的北京5家三甲大医院、深圳等地公立医院的试点改革相继展开。中国卫生部新闻发言人邓海华9日将北京的做法称为积极探索，他并指出，医院措施得当。

China's official will reform of public hospitals as new medical center。July，Including the Beijing friendship hospital, five big 3 armour hospital、Shenzhen public hospital pilot reform of expansion。China's health ministry spokesman DengHaiHua 9, the practice of Beijing is called active exploration，He and points out that，Hospital proper measures。

　　作为全球第二大经济体，中国正经历社会转型，在近10年的迅速发展中，像北京友谊医院这样的公立医院改革起于微末，然而其难度并不亚于一些牵动社会命脉的“大改革”。升高的挂号费(医事服务费)，政府财政负担加重，各方是否能达到“皆大欢喜”的局面，带着这些问题，中国公立医院还将迎来进一步考验。(完)

As the world's second largest economy，China is going through the social transformation，In nearly 10 years of rapid development，Like Beijing friendship hospital such public hospital reform in the poorest，But the difficulty is not less than some affects the social lifeblood“Big reform”。Rising the registration fee(Medical service charge)，The government financial burden，If the parties can achieve“happy”situation，With these problems，China will further public hospital in the test。(finish)