中国医改的创新实践与探索 The innovation of Chinese medical practice and exploration

　　2009年3月，中共中央、国务院颁发《关于深化医药卫生体制改革的意见》，提出到2020年实现人人享有基本医疗卫生服务的目标。深化医改是贯彻落实科学发展观的重大实践行动，是维护13亿中国人民健康福祉的重大民生工程，也是协调推进经济社会建设、扩大内需的重大发展工程。3年来，深化医改探索了路子，积累了经验，取得了重大阶段性成效，为持续深入推进改革打下了坚实基础。同时也要看到，医改取得的成就还是初步的、阶段性的，离实现2020年人人享有基本医疗卫生服务目标还有很长的路要走。我们必须进一步统一思想，加大力度，打好医改攻坚战，继续探索医改这一世界性难题的中国式解决办法。

In march of 2009,The central committee of the communist party/Issued by the state council[On deepening the reform of medical care system opinion],Puts forward to 2020 years to achieve everyone will have access to basic medical and health services goal.Deepening reform, is implementing the scientific concept of development of great practical action,Is the maintenance of 1.3 billion Chinese people's health, well-being of the people's livelihood engineering major,Also coordination promote economic and social construction/To expand domestic demand of major development projects.Three years,Deepening reform, explore the way,Accumulated experience,Made great stage effect,For continuous deepening reform laid a solid foundation.At the same time also want to see,The achievements of the reform, or preliminary/gradual,From achieve 2020 everyone will have access to basic medical and health services goal still have a long way to go.We must further unify their thinking,Intensify efforts to,Play tough sell medical reform,Reform, continue to explore the worldwide problem of Chinese solution.

一、中国医改的主要特点 a/The main characteristics of China's reform

　　《关于深化医药卫生体制改革的意见》颁布后，国务院出台了《医药卫生体制改革近期重点实施方案(2009—2011年)》，重点推动加快推进基本医疗保障制度建设、初步建立国家基本药物制度、健全基层医疗卫生服务体系、促进基本公共卫生服务均等化、推进公立医院改革试点等五项重点改革。目前，五项重点改革任务全面完成，阶段性预期目标基本实现。3年来，我们从实际出发，正在用中国式办法破解医改这一世界性难题。

[On deepening the reform of medical care system opinion]issued,The state council issued a[Medical and health system reform the key implementation plan(In 2009-2011)],Accelerate the key to promote the basic medical security system construction/Initially established a national system for basic drugs/We will improve grassroots medical and health service system/Promote equal access to basic public health services/Advance trial reform of public hospitals and so on five key reform.At present,Five key reform tasks completed,Periodic anticipated goal to realize basic.Three years,We from reality,Is using the Chinese way to cure crack a worldwide problem.

　　第一，坚持“三个基本”。在改革中，中央提出了坚持将基本医疗卫生制度作为公共产品向全民提供的基本理念，坚持保基本、强基层、建机制的基本原则，坚持统筹安排、突出重点、循序推进的基本路径。这“三个基本”是医改这一世界性难题中国式解决办法的核心。许多改革创新举措和实践都源于这“三个基本”。例如，按照基本理念的要求，政府办的医疗卫生机构是提供公共产品的主要载体，应该是公益性的，而不是营利性的。必须增加政府投入，破除“以药补医”机制，建立起维护公益性、调动积极性、保障可持续的运行新机制。

The first,Adhere to the"Three basic".In the process of reform,The central proposed will adhere to the basic medical and health system, as public products to provide the basic concept,Adhere to the basic/Strong base/The basic principle of building mechanism,Adhere to the overall arrangement/Highlight the key/In advance of the basic path.this"Three basic"Cure is a worldwide problem, the core of Chinese solution.Many innovation measures and practice comes from this"Three basic".For example,According to the requirements of the basic idea,Government does medical and health institutions is to provide public products in the main carrier,Should be the public welfare,Rather than profit.Must increase government investment,break"In medicine for medical"mechanism,Establish maintenance public welfare/Arouse the enthusiasm of/Guarantee sustainable operation mechanism.

　　第二，坚持从基本入手、从基层改起。医改涉及的利益关系错综复杂，只有找到突破口，才能顺利推进。深化医改把医疗卫生服务分为基本和非基本，政府的主要职责是履行好“保基本”，非基本医疗主要交给社会去办，政府对医疗市场进行必要的监管和调节。改革选择从基本入手，从最薄弱的环节改起，把大量的资金、财力投向基层，把更多的人才、技术引向基层，使广大人民群众能够尽快从改革中得到更多实惠，从而激发对医改的拥护、支持和信心。

The second,Adhere to the basic of from/From the basic change up.In reform, the benefit relationship of the complex,Only to find a breakthrough,Can smoothly development.Deepen the reform, the medical and health services are divided into basic and the basic,The government's main duty is to perform well"The basic",The basic medical mainly to the society to do,The government to the medical market necessary supervision and regulation.Choose from the basic of reform,From the most vulnerable part of the change,Put a lot of money/Financial resources to the grassroots,Put more talents/Technology to grass-roots,Make the masses as soon as possible to get more benefits from the reform,Thus stimulates cure to support/Support and confidence.

　　第三，坚持把增加投入与建新机制结合起来。深化医改必然伴随大量的投入，但是，如果增加的投入没有和体制机制的改革创新结合起来，不仅不能促进改革，还很有可能固化旧有的利益格局，为下一步改革增加阻力。因此，我们强调增加投入必须和新机制的建设结合起来，用投入促改革、建机制。随着新机制的逐步建立，广大医务人员真切感受到条件的改善和待遇的提高，从而更加支持、拥护改革。同时，新机制也为建立中国特色基本医疗卫生制度打下了坚实基础。

The third,Insist that increase input and a new combined mechanism.Deepening reform, inevitable with a lot of input,but,If increased their spending no and mechanism reform and innovation of the combination,Not only can not promote reform,Also is likely to curing the old pattern of interests,For the next step reform increase resistance.therefore,We emphasize increasing input and the construction of the new mechanism must be combined,With investment to promote reform/Built mechanism.With the gradual establishment of new mechanism,The medical staff really feel conditions to improve and the improvement of treatment,Thus more support/Support reform.At the same time,Also new for the establishment of China's characteristic basic medical and health system laid a solid foundation.

　　第四，坚持从实际出发，谋划整体设计。中国医改只能从中国的实际出发，照抄照搬任何一个国家的模式都不可能取得成功。我们坚持从实践中来，到实践中去，在中央确定改革的方向、原则和基本框架后，鼓励各地进行试点、探索，取得成功经验再总结、提炼，上升为国家政策，然后在全国范围内推开，保证了改革的整体方案符合中国实际，符合人民利益，符合医疗卫生事业发展规律。

The fourth,Proceed from actual conditions,Overall design plan.China's reform, only from the reality of China,Copy any copy of a country's models could not succeed.We insist on from practice,To practice,In the central to determine the direction of the reform/Principles and basic frameworks,Encourage each district pilot/exploration,Success experience summed up again/refining,Rise to national policy,Then in the nationwide push away,Ensure that the reform of the whole scheme with the reality of China,Accord with the interests of the people,Conform to the law of development of medical and public health services.

　　第五，坚持建立强有力的领导体制和推进机制。新医改的强大推力首先来自于党中央、国务院的坚强领导。为推进改革，国务院成立了由20个部委组成的医改领导小组，李克强副总理亲自担任组长，领导全国的医改工作。各地相应成立医改领导小组和办事机构，建立医改目标责任制，层层分解落实改革任务，加大督促检查力度。这种领导体制和推进机制为全国医改的推进提供了有力有效的组织保证，也充分体现了我们的政治优势和制度优势。

The fifth,Adhere to establish strong leadership system and promoting mechanism.The new medical reform powerful thrust first from the party central committee/The strong leadership of the state council.In order to promote the reform,The state council established by 20 ministries and commissions of the leading group of medical reform,Vice premier li keqiang himself as a leader,Under the leadership of the reform of the work.All established corresponding reform leading group and agencies,Establish medical reform target responsibility system,Layer upon layer decomposition implement reform task,Increase supervise and check the strength.The leadership system and promoting mechanism for the advancement of medical reform provides a powerful effective organization guarantee,Also fully embodies our political advantage and institutional advantages.