对话人 Lady who was

　　本报记者 李红梅

Our reporter LiGongMei

　　北京大学中国经济研究中心教授 李 玲

The China center for economic research at Peking University professor li ling

　　上海交通大学公共卫生学院教授 马 进

Shanghai jiaotong university professor in the school of public health, horse

　　

【新闻背景】 【News background】

　　广州市城镇居民医保收不抵支，去年亏空近2亿元，政府日前表示承担资金缺口。

Guangzhou medical insurance for urban residents do not receive to branch，Last year the deficit nearly 200 million yuan，The government has said bear financing gap。

　　城镇居民医保是我国三大基本医保制度之一，主要覆盖非从业城镇居民。有人担心，这部分人群缺乏经济来源，不少人参保不积极，城镇居民医保会不会收不抵支？

Medical insurance for urban residents in China is one of the three basic medical insurance system，Mainly cover non-employed urban residents。There are fears that the，This part of the crowd lack of economic source，Many people ginseng protect not positive，Medical insurance for urban residents will be won't take not to branch？

　　截至去年底，全国城镇居民医保基金累计结余达413.57亿元，整体上并不存在上述问题。

By the end of last year，The national medical insurance for urban residents funds accumulated balance up to 41.357 billion yuan，On the whole the above problems do not exist。

　　那么，为何部分地区居民医保会出现收不抵支的情况？又为何有人不愿意加入居民医保？居民医保收不抵支的情况该如何防止？

so，Why parts of the medical residents will be the team does not arrive？Why some people don't like to join medical residents？Medical residents do not receive to a situation how to prevent？

　　

【核心观点】 【Core ideas】

　　观点一

Viewpoint a

　　医保资金的使用在年初有一个估算，是按照正常参保人群的患病率来测算的。如果随时可参加，而且有病才参加，那么可能会导致医保收不抵支的情况。

Health care in the use of funds in the beginning of the year there is a estimation，According to the normal ginseng protect the prevalence of the measure。If at any time can attend，And sick to attend，So may result in the health care to touch a situation。

　　观点二

View two

　　医院的属性必须改变。不改变创收机制，医保的钱增加再多都兜不住。

The hospital attribute must change。Don't change creates income mechanism，Medical insurance money increase more than are not pocket。

　　观点三

View three

　　三种医保走向统一，筹资、报销等标准都合一，发挥保险“大数法则”的效应，能在更高的层次上解决收不抵支的问题。

Three kinds of medical insurance to unity，financing、To submit an expense account, etc and standard，Play insurance“Law of large number”effect，Can be in a higher level to solve the problem of a charge does not arrive。

　　广州城镇居民医保去年亏空近2亿元，日前政府表示承担资金缺口居民医保，怎么预防收不抵支对话人本报记者李红梅北京大学中国经济研究中心教授李玲上海交通大学公共卫生学院教授马进

Guangzhou medical insurance for urban residents last year the deficit nearly 200 million yuan，Recently the government says bear financing gap residents medical insurance，How to prevent close not to a lady who was our reporter LiGongMei Beijing university professor of the China center for economic research LiLing Shanghai jiaotong university school of public health MaJin professor

　　

一 问 收不抵支因参保不积极？ Ask a close not to branch for ginseng protect not positive？

　　记者：据了解，尽管政府有关工作人员想尽办法，但是有些居民仍不太愿意参加医保，或是有病才参加医保，主要原因是什么？

reporter：It is understood，Although the government officials tried，But some people are still not too willing to participate in medical insurance，Or sick to participate in medical insurance，The main reason is what？

　　李玲：按照《国务院关于开展城镇居民基本医疗保险试点的指导意见》，城镇居民医保参保范围主要为不属于城镇职工基本医疗保险制度覆盖范围的中小学阶段的学生(包括职业高中、中专、技校学生)、少年儿童和其他非从业城镇居民都可自愿参加城镇居民基本医疗保险。

LiLing：According to the《The state council about to carry out pilot basic medical insurance for urban residents of the instruction opinion》，Medical insurance for urban residents do not belong to ginseng protect range mainly for the basic medical insurance system for urban employees coverage of the middle and primary school stage of the students(Including vocational high school、Technical secondary school、Technical school students)、Young children and other non-employed urban residents may voluntarily participate in the urban resident basic medical insurance。

　　相对职工来说，这部分人群缺乏经济来源，收入较低，即使是政府有补助，他们也不一定愿意掏这部分钱。

Relative worker for，This part of the crowd lack of economic source，Low income，Even government subsidies，They are not willing to take the money。

　　此外，我国的医保基本上以自愿为主，不是强制性的，但是我国发挥体制执行力强的优势，目前已经基本上实现全民基本医保。如今，医保报销水平比原来高很多，居民参保的积极性还是比较高的。

In addition，Our medical insurance basically are willing to give priority to，It is not mandatory，But our country play system execution strong advantage，At present has basically realized the basic medical insurance。now，Medical insurance to submit an expense account level than the original high many，Residents of ginseng enthusiasm or higher。

　　只是公立医院创收机制有问题，看病负担仍然较重。

Only public hospital creates income mechanism has a problem，The doctor burden heavier still。

　　记者：参保不积极，有病才参保，这种情况会不会造成收不抵支的发生？

reporter：Ginseng protect do not actively，Sick to ginseng protect，This kind of situation will not cause the occurrence of a charge does not arrive？

　　马进：现在很多地方的医保实行随时可以参加，次月生效的管理模式，但这种模式容易产生问题。

MaJin：Now a lot of local medical insurance practice can attend，Second month effective management mode，But this model easy to cause problems。

　　因为医保资金的使用在年初有一个估算，是按照正常参保人群的患病率来测算的。如果随时可参加，而且有病才参加，那么会导致医保收不抵支的情况。

Because of health care in the use of funds in the beginning of the year there is a estimation，According to the normal ginseng protect the prevalence of the measure。If at any time can attend，And sick to attend，So will lead to the medical insurance to touch a situation。

　　因此，应该设置准入门槛，建立激励约束机制，让符合条件的参保人尽量都在年初参保，减少这种情况的发生。

therefore，Should be set admittance threshold，To establish incentive and restraint mechanism，To meet the conditions of the ginseng protect people try to all in the beginning of the year ginseng protect，To reduce the happening of this kind of circumstance。