“无论从横向的国际比较，还是从纵向的历史比较来看，中国的新医改都已经取得了十分重要的阶段性成果。”美国哈佛大学公共卫生学院教授刘远立近日接受本报记者专访时这样表示。

“No matter from horizontal international comparison，Or from the history of longitudinal compared to see，China's new cure all have made important achievements。”Harvard University school of public health professor LiuYuanLi recently accept our reporter interview say。

　　刘远立从1994年起一直在哈佛大学从事国际卫生政策与管理的科研和教学工作, 是“卫生体系学”创始人之一，哈佛大学公共卫生学院“中国项目部”主任。他说：“这些年来，我一直密切关注中国医改的进程，平均每年回中国五六次，每次都能看到新的进步和变化。”不久前，他应邀参加北京市医改创新成果评选活动，还到湖北、广西、四川等地调研。“所到之处，无不对基层医疗机构新建或翻修工程之普遍、医保覆盖面扩大所带来的医疗需求释放程度之大留下深刻印象。”

LiuYuanLi since 1994 has been engaged in international health policy at Harvard University and management of the scientific research and teaching, is“Health system to learn”Was one of the，The harvard school of public health“China project department”director。He said：“Over the years，I always pay close attention to the process of cure of China，In an average year back to China five or six times，Every time you can see new progress and change。”Not long ago，He was invited to Beijing medical innovation achievement poll，Also to hubei、guangxi、Sichuan province, research。“where，All of the basic level medical institutions for new or renovated engineering generally、Medical insurance coverage expanded brought about by the release of medical needs degree left deep impression。”

　　刘远立认为，建立医疗保障制度的目的，一方面是降低人们就医时的经济障碍，让患者及时得到服务；另一方面是减少“因病致贫”。2011年末与2008年相比，中国新增参保人数1.62亿，世界上还没有第二个国家在这么短的时间做到这一点。目前，中国基本医疗保障制度的人群覆盖率(名义覆盖率)已经达到95%，基本实现全民医保。与此同时，中国基本医疗保障的水平也在大幅提升。政府对新农合与城镇居民医保的补助标准从2009年的每人每年80元提高到2011年的200元，特别是大幅度提高了农村儿童白血病和先天性心脏病患者的保障水平。这些变化带来的直接作用就是，让原先被压抑的医疗服务需求被迅速地释放出来。

LiuYuanLi think，The purpose of the establish the medical security system，On the one hand is to reduce people when go to a doctor of economic barriers，Let the patient to be service；On the other hand is reduced“Become financially-difficult or”。By the end of 2011 compared with 2008，China's new ginseng protect number 162 million，The world does not have the second country in such a short time to do this。At present，China's basic medical insurance system crowd coverage(Name coverage)Has reached 95%，Basic achieve universal coverage。At the same time，China's basic medical insurance in the level also increased greatly。The government of new farming, and medical insurance for urban residents subsidies standards from 2009 80 increase per person per year in 2011 to 200 yuan，Especially for rural children greatly improve leukemia and congenital heart disease patients safeguard level。These changes is the direct effect，Let originally were depressed medical service needs be released quickly out。

　　刘远立说，中国卫生部的调查资料显示，2011年与2008年相比，全国年住院率提高了8.5%，住院病人因经济原因提前自行出院的比例相应地降低了7.5%。与此同时，发生大额医疗支出的家庭比例在新医改实施3年间降低了2.6%。“每当我看到新农合报销窗口前的‘热闹’景象，都会为在中国农村这块土地上所发生的翻天覆地的变化兴奋不已。”

LiuYuanLi said，China's health ministry survey data shows，In 2011, compared with 2008，The national hospitalization rate increased by 8.5%，Hospital patients because of economic reasons to advance the proportion of discharge correspondingly decreased 7.5%。At the same time，Large amount of medical expenses occurred in new medical family proportion implementation 3 years was reduced by 2.6%。“Whenever I see new farming and submit an expense account of the Windows‘lively’scene，In rural China will be the land of what happened in the span of excitement。”

　　这几年的冬季，刘远立都会带领一个由来自不同国家成员组成的“哈佛研究生中国卫生考察团”，到中国做为期三周的调研。刘远立说：“大家一致认为，中国的基层医疗卫生机构通过短短几年的建设，面貌焕然一新，是世界上的一个‘奇迹’。”

These years of winter，LiuYuanLi will lead a by members from different countries“Harvard graduate student Chinese health tour”，To China for three weeks of investigation。LiuYuanLi said：“Everyone agreed that，China's basic medical and health institutions through just a few short years of construction，Appearance to look brand-new，Is the world of the one‘miracle’。”

　　刘远立认为，由于健康与医疗卫生保健本身的复杂性，任何医改都必然是复杂而艰巨的，更何况在世界上人口最多的国家中国。

LiuYuanLi think，Because of health and medical health care itself of complexity，Any medical must be complex and difficult，Besides in the world's most populous country China。

　　关于中国医改未来的发展方向，刘远立认为，中国医改未来有两项主要任务：一是发展完善，拾遗补缺；二是改革创新，巩固和提高已取得的阶段性成果。就医疗保障制度而言，在“名义覆盖率” 已基本实现覆盖全民的基础上，接下来应注重提高 “有效覆盖率”。中国大概有2.1亿流动人口，其中大部分人虽参加了新农合，但目前的制度设计还没有考虑到如何及时报销他们的医疗费用。要真正建立起一个公平、高效、可持续的医药卫生体系，就必须遵循“三明”原则，即目标清明、手段精明、奖惩严明。中国在清晰界定了医改总目标的基础上，还要有一个个明确的、可实现和可测量的子目标。　(本报驻美国记者 温 宪)

About the future direction of the cure of China，LiuYuanLi think，China future cure of the two main task：One is well developed，Shortage make-up；Two is to reform and innovation，Consolidate and enhance the has made some progress。Medical security system is concerned，in“Name coverage” Cover the has already realized basically based on，The next should pay attention to improve “Effective coverage”。China has an estimated 210 million floating population，Though most of them in new farming $，But the current system design is not considering how to submit an expense account in their health costs。To really set up a fair、efficient、Sustainable of medical and health system，We must follow“sanming”principle，Goal is clear、Means smart、Strict rewards and punishment。China in clear defining the total cure on the basis of the goal，Must have a clear、Can realize and measurable objectives。(Our newspaper reporter in the United States constitution temperature)