医改一小步，引发大关注--北京深圳公立医院取消药品加价追踪 Brought a small step，A large concern-Beijing shenzhen public hospital cancel drugs increase tracking

　　今年7月以来，北京、深圳两地公立医院陆续取消药品加成收费，同时设立阶梯定价的医事服务费等，这些医改举措引起了社会各界的广泛关注。

Since July this year，Beijing、Shenzhen public hospitals have cancelled drug charge bonus，While establishing a ladder of medical service charge and pricing，The cure of the move caused the wide attention of all social sectors。

　　卫生部部长陈竺近日在北京友谊医院调研时表示，医改撕掉了“以药养医”的标签，取得了初步成效，下一步将适度扩大改革范围。

Health minister Chen middle&small recently in the Beijing friendship hospital research said，Tore down the cure of the“To raise the medical medicine”label，Acquired preliminary achievements，The next step will be moderately expand scope of reform。

　　连日来，新华社“新华视点”记者探访京、深两地医改一线，对此次医改相关问题进行了追踪采访。

In recent days，The xinhua news agency“Xinhua viewpoint”Reporter visits Beijing、Both a deep cure of the line，For the medical problems related to tracking the interview。

　　药品“零加成”，一次便宜百元 drug“Zero bonus”，A cheap one hundred yuan

　　7月1日起，北京率先在友谊医院实施“零加成”，超过1500种药品入列。目录中最贵的即复宁粉针，从原价2995.75元，下降至2605元。

July 1,,，Beijing took the lead in the friendship hospital implementation“Zero bonus”，More than 1500 kinds of drug waited。The most expensive in the directory is after better injection，From the original price of 2995.75 yuan，Descend to 2605 yuan。

　　与此同时，深圳也在公立医院全面取消药品加成，涉及2962种医保目录药品，药价是以前的“八五折”甚至是“七五折”。

At the same time，Shenzhen public hospital in comprehensive drug bonus cancelled，Involving 2962 kind of medical insurance directory drugs，Is the drug prices before“Get a discount of”even“discount”。

　　统计显示，半个多月来，北京友谊医院的医保患者次均药费比照上半年次均药费下降了100.44元，降幅接近三成。

Statistics show that，Half a month to，Beijing friendship hospital's medical insurance expenses second all patients in the first half second all expenses for medicine, mutatis mutandis, down 100.44 yuan，By close to thirty percent。

　　友谊医院院长刘建解释说，取消药品加成，也就是让药品从进入医院药房到被患者按处方买回家，医院不加收任何费用，取消了大约15%的药品加成费用。

Friendship hospital director LiuJian explained，Cancel the drug addition，Also is to let the drug from to enter the hospital pharmacy to be bought by the patient's prescription back home，The hospital not charge any costs，Canceled about 15% of drug bonus cost。

　　“一次便宜几百元，处方现在‘瘦身’了。”“药价降下来，想想心里就高兴。”记者走访北京友谊医院、深圳市中医院等听到了患者肯定的声音。

“A cheap hundreds of yuan，Prescription now‘Thin body’the。”“Drug prices come down，Think about was happy。”Reporter visit Beijing friendship hospital、Shenzhen hospital and heard the voice of the sure patients。

　　另一方面，也有患者反映，管了医院不加价，还要管一管医生这支笔。首钢退休工人王胜永说：“医院不搞加成了，医生可劲儿推荐一种药，那你也要打个问号。”

On the other hand，Also have patients reflect，Tube hospital is not a premium，Even a tube tube doctor that pen。Shougang retired workers WangShengYong said：“Don't make a bonus to the hospital，The doctor may recommend a medicine is，Then you also want to make a question mark。”

　　北京市医改办主任韩晓芳说，取消药品加成后，医生与医药代表之间若再有勾连，也容易暴露出来，便于院方监督检查，从严查处和惩戒。

Beijing medical director for HanXiaoFang said，Cancel after drug bonus，Doctors and medical representatives if again between references，Also easy exposed，The supervision and inspection to the hospital，Severely penalize and retribution。

　　据了解，在北京，有不少三甲医院设立了“大处方审核”机制。如友谊医院，一旦出现1000元以上的大处方，电脑系统立刻就会发出预警。

According to understand，In Beijing，There are many 3 armour hospital set up“DaChuFang audit”mechanism。Such as friendship hospital，Once appear, 1000 yuan of above DaChuFang，The computer system can issue warning immediately。

　　医院增减调整，政府能否“输血”？ Hospital increase or decrease adjustment，The ability of the government to“Blood transfusion”？

　　长期以来，“药费比例过高”一直是群众反映强烈的问题。公立医院取消药品加价后，一些患者担心会不会再增加其他的负担，比如增加检查费用。

long，“Expenses for medicine high proportion”Has been the populace reflects intensely problem。Public hospital cancel drug after the price hike，Some patients worry will not add another burden，Such as increased examination expenses。

　　京、深两地医改部门告诉记者，这次医改采取的是一种平移方法，北京通过取消挂号费、诊疗费和药品加成，设立阶梯定价的医事服务费，门诊分42元、60元、80元、100元四等；深圳也在逐步调整诊费价格。

Beijing、Two deep medical department told reporters，The cure of the taken a translation methods，Beijing through the cancel the registration fee、Fee and drug addition，Set up a ladder of medical service charge pricing，Outpatient service points $42、60 yuan、$80、100 yuan four etc.；Shenzhen also gradually to adjust the price fees。

　　刘建说，此次医改后，患者相当一部分负担由医保托底，这意味着患者担心的其他费用涨价不会发生，甚至随着改革深入，检查费等也可能有所下降。

LiuJian said，After the cure of the，Quite a number of patients by medical insurance TuoDe burden，This means the patient to worry about other expenses prices won't happen，Even with the reform deeply，The inspection fee, etc may also fell。

　　然而，还是有一些患者担心这种类似“拆东补西”“一减一增”的方式，会不会是“羊毛出在羊身上”？

however，There are still some patients are worried about the similar“robbing”“One minus one increase”way，Will be“The wool in the sheep”？

　　韩晓芳解释说，新的制度设计，是一种结构性调整，通过阶梯定价，使普通门诊与专家门诊的价格落差拉开至58元，比以往的9元有了很大进步，更尊重和体现医务人员的技术服务，使医院从主要依靠“卖药”生存发展，逐步转变为靠医疗技术服务生存发展。

HanXiaoFang explained，The new system design，Is a structural adjustment，Through the ladder pricing，The average outpatient service and expert outpatient service price gap opened to 58 yuan，Than the previous nine yuan had the very big progress，More respect and reflect the medical staff technical service，Make the hospital from mainly rely on“Sell medicine”Survival development，Change to rely on medical technology service for survival and development。

　　半个多月来，友谊医院的医事服务费用正在改变患者的就医习惯，专家门诊次均就诊时间提高到约16分钟；同时，普通门诊量占比上升至80.6%。

Half a month to，The friendship hospital medical service fee is changing the medical patients habit，Expert outpatient service second all time to get up to about 16 minutes；At the same time，MenZhenLiang than ordinary of rose from 80.6% to。

　　一些亲历改革的医院院长分析，此次“一减一增”的医改过程中，药品从医院的收益来源转换为“成本”，其仓储和管理费用明显增加，实行诊费阶梯定价也只能弥补一部分费用，其他支出缺口还需要财政资金扶持。

Some experience of the reform of hospital analysis，the“One minus one increase”The cure of the process，Drugs from the hospital source of revenue for the conversion“cost”，The storage and management fees increased significantly，The price also can only make up fees ladder part of the costs，Other spending gap still need to finance capital support。

　　专家指出，从发达国家的经验看，公立医院的发展必须有政府财力的支持。

Experts point out that，From the experiences of developed countries look，Public hospital development must have the government financial support。

　　据了解，目前京深财政部门已设立公立医院补偿机制。北京市财政部门承诺将确定医院补助标准，结合服务量进行补偿，并设考核奖金；深圳市医改部门负责人也表态，将建立科学、合理的补偿机制，草拟方案正报请审批。

According to understand，At present the deep financial department has established a public hospital compensation mechanism。The financial department of the Beijing promises to determine the hospital allowances，Combined with services to compensate，And set assessment bonus；Shenzhen medical director of the department also comment，Will establish a scientific、Reasonable compensation mechanism，Draft plan is submitted to the examination and approval。

　　求解看病难与贵，医改还有哪些招？ Solving difficult and expensive to see a doctor，What other medical recruit？

　　7月以来，尽管取消药品加成等措施受到群众好评，但是解决“看病难”“看病贵”问题仍然十分复杂，不可能一蹴而就。

Since July，Although cancelled measures such as the drug addition by high praise，But solving“Difficulties in getting”“High cost”Problems still very complex，May not come easily。

　　中国经济体制改革研究会公共政策研究中心主任余晖认为，正在进行的公立医院改革已触及“看病难与贵”的一些根本性矛盾，但要真正解决这些矛盾，仍需从内部及外部多方寻找改革动力。

China's economic system reform of public policy research center director that evening glow，The ongoing reform of public hospitals have reached“Difficult and expensive to see a doctor”Some of the fundamental conflict，But to really solve these conflicts，Still need from internal and external many looking for reform momentum。

　　比如在北京，一些大医院人满为患，而一些中小医院病员不足，这种现象就如同教育领域的重点学校、重点班一样，属于优质资源配置不合理的问题，有待于医疗行政部门从系统内部加以改革与调整。

For instance in Beijing，Some big hospital overcrowded，And some small hospitals lack the sick，This phenomenon is like the key school of education field、ChongDianBan as，Belong to high quality resource configuration is not reasonable，To be medical administrative department within the system reform and from adjustment。

　　又比如，在一些医院，患者一进门，医生就让你去检查这、检查那，然后开一大堆药品，以至于一些患者碰到大的检查不敢去做，大的处方不敢去缴费，解决这类问题，仅靠医疗系统自身的改革恐怕也很难奏效。

And such as，In some hospitals，Patients a door，The doctor let you to check it、Check the，Then open a lot of drugs，That some patients have a check of do not dare，Big prescription dare to pay cost，To solve this kind of problem，Only on the reform of medical system itself probably hard to work。

　　北京大学中国卫生经济研究中心主任刘国恩教授认为，公立医院不仅需要内部的改革，同时还需要来自外部的改革，特别是引入不同所有制形式的医疗竞争主体，通过外力倒逼，为公立医院改革增添生机与活力。

Beijing university Chinese health center for economic research director LiuGuoEn professor considered，Public hospital needs not only internal reform，It would also need from outside of the reform，Especially introducing different system of ownership form of medical competition subject，Through the external force DaoBi，For public hospital reform add vitality and dynamism。

　　据了解，今年4月，国务院办公厅印发的《深化医药卫生体制改革2012年主要工作安排》要求，在积极推进公立医院改革的同时，大力发展非公立医疗机构；还要求各地要尽快出台鼓励社会资本举办发展医疗机构的实施细则。

According to understand，In April this year，Issued by the general office of the state council《Deepen the reform of the medical care system in 2012 major work arrangement》requirements，In promoting public hospital reform at the same time，Vigorously developing the public medical institutions；Also requires all come to encourage social capital as soon as possible for the development of the detailed rules for the implementation of the medical institution。

　　专家指出，建立公办与民办并举的基本公共服务供给模式，也是国务院日前公布的《国家基本公共服务体系“十二五”规划》的明确要求，这一规划鼓励社会资本参与部分公立医院改制重组等。

Experts point out that，Establishment of public and private and basic public service supply mode，The state council is released《The state's basic public service system“1025”planning》Clear requirements of，This planning encourage social capital of part of public hospital restructuring, etc。

　　专家提出，调动更多的社会资源，并不一定损害公益性原则。有了多种资源的参与，公立和私立机构互相竞争，这样才能促进有限资源的合理配置。

Experts suggest，To mobilize more social resources，Must not damage public welfare principle。With the multiple resources participation，Public and private institutions to compete against each other，Like this can promote limited the rational allocation of resources。

　　(记者许晓青、李亚红、赵琬微、吴俊)

(Reporter XuXiaoQing、LiYaGong、Zhao Wan micro、Wu2 jun4)