中新网8月31日电 (邓永胜)大病保险实际报销比例不低于50%、不额外增加参保者缴费负担、加强对商业保险机构承办大病保险监管、解决因病致贫、因病返贫问题……在全民医保体系逐步建立、医改向纵深挺进之际，国家发改委、卫生部等六部委日前公布《关于开展城乡居民大病保险工作的指导意见》。这一新政力求补齐医保政策短板，让老百姓真正实现病有所医。

Beijing, aug. 31 (DengYongSheng)A serious illness insurance actual expense proportion is less than 50%、No additional participants pay cost burden、Strengthen the commercial insurance institutions undertaking serious illness insurance regulation、Solve become financially-difficult、Poverty due to illness problem...In the medical insurance system gradually established、To deep the reform into，The national development and reform commission、The ministry of health announced six ministries and commissions such as《About urban and rural residents to carry out a serious illness insurance work guiding opinions》。The New Deal for medical insurance policy together to short plate，Let people really multi-form。

　　

热点新闻事件拷问大病医保缺陷 Hot news events torture a serious illness medical insurance defect

　　大病保障是衡量一个国家医疗保障水平的重要标志。中国全民基本医保已经覆盖城乡，但大病保障制度尚不健全，群众大病医疗费用负担仍然较重，因病致贫、因病返贫的问题和风险还比较突出。而近期连续断出现的热点新闻事件则让这一缺陷不断凸显。

A serious illness security is the measure of a country the important symbol of the levels of medical security。China national basic medical insurance has been covering both urban and rural areas，But serious illness security system is not perfect，The medical treatment of a serious illness expense burden is heavier，Become financially-difficult、The problem of poverty due to illness and risk is relatively conspicuous。And the recent continuous break appear hot news event, let this defect unceasingly highlighting。

　　丈夫为救病妻私刻公章诈骗、孝子买农药助母安乐死、老太拾荒为去世儿子还医疗债务……几个看似彼此孤立的热点新闻事件，却多因“难堪沉重医疗费”而起。在经过媒体广泛报道后，中国当前医保政策存在的缺陷，特别是大病医疗救助这一“短板”再度被推向舆论的风口浪尖。

Her husband to save disease wife SiKe official seal fraud、Buy pesticide and help mother euthanasia、Granny glean and collect scraps for the son's death also medical debt...Several seemingly isolated from one another hot news events，But more because“Embarrassed heavy medical expenses”And the。After the media after the widely reported，China's current medical insurance policy defects，Especially the medical treatment of a serious illness salvage this“Short plate”Had been to the opinion in the teeth of the storm。

　　在备受关注的“私刻公章救妻”案中，男主人公廖丹的妻子杜金领既无北京户口，又未曾在京办理医疗保险，被“顺理成章”的挡在北京大病医保的门外。

The controversial“SiKe official seal to save his wife”case，Hero LiaoDan wife DuJinLing have neither Beijing hukou，And in Beijing have not of the medical insurance，was“logical”In a serious illness in Beijing medical insurance door。

　　在多次诉诸正当渠道无果后，救妻心切的廖丹选择了一条触及刑律的道路。他私刻医院收费章，四年为妻子换来400多次免费透析机会，涉案金额17.2万元。

In the multiple resort to proper channel after inconclusive，Eager to save his wife LiaoDan chose a touch the way of criminal law。He SiKe chapter hospital fees，Four years for 400 times for his wife free dialysis opportunity，Involving a value 172000 yuan。

　　涉嫌诈骗，将面临刑事处罚，这样一个违法者连同病妻在被媒体报道后却得到了公众一边倒的同情。很多网友认为，正是大病救助的缺位和医保制度的漏洞，令走投无路的廖丹选择“铤而走险”。在惩罚违法者的同时，更应检讨大病救助制度的缺陷。。

Suspicion of fraud，Will face criminal penalties，Such an offender along with disease wife is in the media but get public one-sided sympathy。Many netizens think，It is a serious illness salvage the lack of medical insurance system and the loopholes，Make the desperate LiaoDan choice“Rush in where angels fear to tread”。At the same time in punishing offenders，We should review the serious illness salvage system defects。。

　　针对这一现实情况，此次出台的大病医保新政明确提出，要合理确定大病保险补偿政策，实际支付比例不低于50%；按医疗费用高低分段制定支付比例，原则上医疗费用越高支付比例越高。

According to the reality，The on the introduction of the New Deal a serious illness medical insurance put forward，To reasonably determine the serious illness insurance compensation policy，The actual payment proportion is less than 50%；According to the medical treatment charge high and low section make payment proportion，In principle, the higher proportion of medical expenses paid higher。

　　国家发展改革委副主任、国务院医改办公室主任孙志刚表示，开展大病保险，对城乡居民因患大病发生的高额医疗费用给予报销，目的是要解决群众反映强烈的“因病致贫、因病返贫”问题，使绝大部分人不会再因为疾病陷入经济困境。

The national development and reform commission deputy director、Cure of the state council office director SunZhiGang said，To carry out a serious illness insurance，To urban and rural residents suffering from serious illness happen high medical treatment charge gives to submit an expense account，Purpose is to solve the populace to reflect the strong“Become financially-difficult、Poverty due to illness”problems，Make most people won't because disease in queer street。

　　

官方多次表态力求补齐政策短板 The official said many times to polishing policy short plate

　　当前，中国“十二五”医改正向纵深挺进。积极探索建立大病保障机制、使全民基本医保体系不断完善成为重要一环。今年以来，中国官方多次表态，力求补齐大病医保这一短板，不断提升保障能力，解决大病患者特殊困难和后顾之忧。

The current，China“1025”Into the deep reform forward。Actively explore establish guarantee mechanism of a serious illness、Make the basic medical insurance system has improved constantly become important one annulus。Since this year，Chinese officials said many times，Strive to patch together a serious illness medical insurance that a short plate，Continuously improve support capacity，To solve a serious illness patients special difficulties and trouble back at home。

　　今年的《政府工作报告》提出，要全面推开尿毒症等8类大病保障，将肺癌等12类大病纳入保障和救助试点范围。

This year's《The government work report》Put forward，To be fully opened the uremia, eight kind of serious illness security，The lung and 12 kind of serious illness into the security and salvage the scope。

　　《政府工作报告》并指出，建立大病保障制度，必须注重创新机制，把基本医保与商业保险结合起来，相互衔接，功能互补。

《The government work report》And points out that，Establish a serious illness security system，Must pay attention to innovation mechanism，The basic medical insurance and commercial insurance combined，connected，Function complementary。

　　同时，要搞好基本医保、大病保险、医疗救助、慈善救助以及商业补充保险的衔接，探索形成多层次多形式的大病保障制度，不断提升保障能力。

At the same time，To improve the basic medical insurance、Serious illness insurance、Medical assistance、Charity relief and business supplementary insurance of cohesion，To explore more formation of multi-level form of a serious illness security system，Continuously improve support capacity。

　　随后，国务院出台《“十二五”期间深化医药卫生体制改革规划暨实施方案》。其中提到，要加快健全全民医保体系，继续加大政府支持力度，逐步提高城镇居民医保和新农合政府补助标准，加快医保支付方式改革，积极探索建立大病保障机制，使全民基本医保制度不断完善。

then，The state council has rolled out《“1025”During the deepening reform of the drug an medical management planning and implementation plan》。The mentioned，To speed up the perfect the medical insurance system，Continue to strengthen government support，Gradually improve medical insurance for urban residents and new farming together the government subsidies standards，To speed up the reform of the medical insurance payment，Actively explore establish guarantee mechanism of a serious illness，Make the basic medical insurance system continuous improvement。

　　针对农村儿童的大病保障问题，中国乡村儿童大病医保公益基金7月启动。该项目通过多方合力筹集保险资金，采用公益基金、保险公司、地方政府合作的方式，向社会筹募善款，为试点地区适龄儿童购买商业医疗保险，不设病种赔付限制，当地儿童免费获得最高20万元赔付，既可以减轻患儿家庭的负担，也不会给当地财政增加压力，有效解决了乡村儿童大病保障问题。

For rural children's serious illness security，China's rural children serious illness medical insurance public welfare fund July start。The project through the polytropic force raise insurance funds，The public welfare fund、Insurance company、Local governments cooperation way，To raise funds society，For pilot areas school-age children to buy commercial medical insurance，Do not set disease to compensate limit，The local children free and obtain the highest 200000 yuan settlement，Both children can reduce the burden of the family，Won't give the local financial increase pressure，Effectively solve the rural children serious illness security。

　　7月19日，中共中央政治局常委、国务院副总理、国务院深化医药卫生体制改革领导小组组长李克强在国务院深化医药卫生体制改革领导小组第十一次全体会议上强调，要下决心把大病医保纳入全民医保，拓展延伸基本医保功能，这有利于从制度上筑牢、织密社会安全网，解决大病患者特殊困难和后顾之忧，给他们带来希望、带来温暖。

July 19，The standing committee of CCCPC political bureau、Vice premier of the state council、The state council deepening medical health system reform in the state council leading group leader li keqiang deepening medical health system reform leading group eleventh plenary meeting stressed，Should be determined to put a serious illness medical insurance into the universal coverage，Expand the basic medical insurance function extension，This benefit from the system built on the prison、Weave tight social safety net，To solve a serious illness patients special difficulties and trouble back at home，Give them hope、Bring warm。

　　有媒体评论指出，把大病医保纳入全民医保范围，拓展和延伸基本医保的功能，从制度上织密社会安全网，切实解决大病患者的特殊困难，是百姓的殷切期盼，也是政府的应尽职责

Media commentary pointed out，The serious illness medical insurance into the universal coverage range，Extension and the function of the basic medical insurance，From the system on active close social safety net，Solve the special difficulties in patients with a serious illness，Is the people look forward very much，And the government should do one's duty

　　

大病医保新政启程 仍面临诸多挑战 A serious illness medical insurance New Deal set out on a journey still faces many challenges

　　中国出台大病医保新政，对于完善全民医保体系、解决因病致贫、因病返贫问题均具有积极意义。但在大病保障机制的建立和完善的道路上，仍有诸多挑战待解。

China issued a serious illness medical insurance the New Deal，To perfect the medical insurance system、Solve become financially-difficult、Poverty due to illness problem all has the positive sense。But in a serious illness to establish and perfect the safeguard mechanism on the road，There are still many challenges for solution。

　　首先是资金问题。步入老龄化社会的中国，医疗负担会越来越重。此次医保新政明确了资金来源，将从城镇居民医保基金、新农合基金中划出一定比例或额度作为大病保险资金。

The first is the problem of funds。An ageing society of China，Medical burden will be more and more heavy。The medical insurance the New Deal has been clear about the source of fund，From the medical insurance for urban residents fund、New farmers joint funds a certain proportional or line as a serious illness insurance funds。

　　而解决大病患者群体的实际困难，需要大量的医保资金支持。只有为医保蓄水池不断注入“活水”，才能避免医保基金入不敷出。

To solve the serious illness patients group of practical difficulties，Need a lot of medical insurance fund support。Only for medical insurance reservoir continuous injection“Running water”，To avoid the medical insurance fund cannot make ends meet。

　　当前，受城乡二元分割、户籍制度及人口流动等因素的制约，很多不愿承受异地就医和报销繁琐的人被遗漏在医保制度之外。

The current，By urban and rural binary segmentation、The household registration system and population flow restricted by many factors，Many would not bear different medical and submit an expense account trival people were missing in the outside of medical insurance system。

　　同时，各地医疗资源分布不平衡的现状，也使大病治疗经常成为“异地治疗”，很多大病患者医疗费用报销的比例因此大打折扣。而这种不平衡，短期内亦难改变。

At the same time，Medical resources all over the present situation of unbalanced distribution，Also make a serious illness treatment often become“Different treatment”，A lot of serious illness patients medical expense proportion therefore sells at a discount greatly。And this kind of unbalanced，In the short term is difficult to change。

　　此时，由全民医保向全民医保一体化转变的口号呼之欲出。在长期致力于医疗体制改革的北京大学光华管理学院经济学教授刘国恩看来，建立全民医保一体化，解决异地就医和异地结算并不是一件难事，可以通过电子信息化手段，网上交易和结算，网上购物有支付平台，医保报销也同样可以建立网上支付运营平台。

At this time，The universal coverage to universal coverage integration transformation slogan be vividly portrayed。In the long term to medical system reform of the Beijing university guanghua school of management economics professor LiuGuoEn looks，Establish universal health care integration，Solve different medical and remote settlement and is not a difficult task，Can through the electronic information means，Online trading and settlement，Online shopping is payment platform，Medical insurance to submit an expense account also can build online payment operation platform。

　　此外，在全民医保政策不断推进的过程中，医保制度的城乡分割、群体分割和管理与经办分割等碎片化问题也不断显现。

In addition，In the medical insurance policy continuously advancing process，Medical insurance system of urban and rural areas、Group segmentation and management and handling partition fragmentized problems also appeared unceasingly。

　　有专家指出，消灭医保碎片化，实现城乡医保一体化的真正难点在于各部门利益之间的博弈：新农合归属于农业部管理，城镇医疗保险由人社部负责，各地区经济发展不均衡引起的转入地和转出地之间利益此消彼长。若要改变，需要国家政策的大力度调节。(完)

The expert points out，Eliminate medical insurance fragmentized，To realize the integration of urban and rural medical insurance of the real difficulty lies in various departments between interests game：New farmers joint belongs to the ministry of agriculture management，Urban medical insurance by club department is responsible for，Regional economic development caused by the unbalanced turn into the ground and roll out between liquor interests。If you want to change，Need to national policy big strength regulation。(finish)