中新网9月17日电 国务院新闻办公室今日举行新闻发布会，卫生部部长陈竺、副部长刘谦介绍卫生事业改革发展进展情况，并答记者提问。陈竺指出，北京市一些公立医院取消药品加成后设立医师服务费未增加医保负担。

Beijing, sept. 17 - the state council information office held a press conference today,The ministry of health minister Outlines/Vice minister liu qian introduced reform and development of health programs progress,And answer questions.Outlines points out that,Beijing some public hospital drug addition to cancel after service set up doctors did not increase the burden of medical insurance.

　　有记者提问，北京市的一些公立医院取消了药品加成，取而代之设立了医师服务费，用以激励医生提供更高质量的服务。医师服务费有一部分是用医保进行报销的，是40元钱，这是否会在一定程度上增加医保的负担？如何平衡合理使用医保与合理提升医生待遇的关系？

A reporter's question,Beijing's some public hospital cancelled drug addition,Instead, set up the doctor service charge,To motivate the doctor to provide higher quality service.Doctors service charge is part of the medical insurance for with submit an expense account,Is 40 yuan,This would be in a certain extent increase the burden of medical insurance?How to balance the reasonable use of medical insurance and rational ascension doctors treatment relationship?

　　陈竺回答说，从最近北京市和深圳市试点的情况来看，实际上取消以药补医以后，它所设立的医师服务费是在控制总额前提下的一个结构调整。以药补医从机制上造成了很多弊病，是因为医疗技术劳务的价值没有在价格上得到充分的体现。设立医师服务费，提升手术费、护理费以及有些地方在开展的建立药师服务费，是为了把不合理的情况扭转过来，因为药师服务也是有成本。

Outlines answered and said,From the recent Beijing and shenzhen pilot situation,Actually cancel to medicine fill after healing,It is a physician service charge is in total control of the premise of a structure adjustment.To fill medicine medical from mechanism caused many defects,Because the medical technology service value on the price not fully reflected.Set up doctors service charge,Ascension operation/Nurse cost and some places in the establishment of service in medicine,In order to put the unreasonable situation turn over,Because the medicine service is also cost.

　　陈竺还指出，从现在实际的运行情况来看，取消药品加成以后，还带来另外一个效果，就是药品费用下降的幅度超过了取消加成的幅度。

Outlines also pointed out that,From now the actual operation situation,Cancel after drug addition,Also bring another effect,Is the drug expenses from falling over cancel addition of amplitude.

　　陈竺举例指出，友谊医院原来预期取消以药补医以后，药品的费用下降应该是15/115，就是12.7%，也就是加成的这一块，但是实际下降了30%，也就是说过度用药、大处方的情况得到了遏制，取消了以药补医以后，药品的费用成为医院的成本，而不是创收的手段。综合测算下来的结果，实际上北京的做法还为医保省了钱，医保的确要报销医师服务费这一块，但是增加的有限额度，和药费下降的幅度相比，实际上增量还没有超过下降的幅度，所以总的情况就是群众的用药负担减轻了，医院医务人员的行为回归公益性、回归合理了，医保最后省钱了，而且要从未来控制医保不合理增长，这个作用就会更加显现，所以我们认为支付制度的改革在下一步公立医院改革当中是非常重要的。

Outlines points out, for example,Friendship hospital had expected cancel to medicine fill after healing,The cost of drugs should decline is 15/115,Is 12.7%,Is this a bonus,But the actual dropped 30%,That is excessive medication/DaChuFang situation has been contained,Cancel the medicine fill after healing,The cost of the drug as the cost of the hospital,And is not the means of income.The results of comprehensive measuring down,In fact the practice of Beijing for medical insurance save money,Medical doctors really want to submit an expense account service charge this one,But the increasing of the amount of limited,The magnitude of the drop medicine and compared,In fact increment is not more than the magnitude of the drop,So the situation is the masses' medical burden reduced,Hospital medical personnel's behavior regression public welfare/Regression reasonable,The medical insurance last save money,Also from the future to control the medical insurance is not reasonable growth,This action will be revealed,So we think that payment system reform in the next step of reform of public hospitals is very important.

　　陈竺还成，中国医疗的筹资制度安排主要的是建立医疗保障，也就是说建立一个为需方服务的体制。当然绝对不是说我们对供方投入就不应该增加，实际上按照2009年出台的《中共中央 国务院关于深化医药卫生体制改革的意见》明确指出了政府办医的责任，对于公立医院的补偿，包括离退休人员的工资，基础设施建设，大型医疗仪器设备的购置，科学研究、教学，承担的公共卫生任务，支农、支边、援助基层，这些是政府应该对公立医院直接的拨款。

Outlines also into,Chinese medical financing institutional arrangement main is to establish medical security,That is to establish a service system for the buyer.Of course absolutely not say that we have in the supplier should not increase,In fact, in accordance with the 2009 published[The central committee of the communist party the state council on deepening the reform of medical care system opinion]Clearly points out the government responsibility of healing,For public hospital compensation,Including retired personnel's wage,Infrastructure construction,Large medical equipment purchase,Scientific research/teaching,Undertake public health task,support/wants/Aid grassroots,These are the government should to public hospital direct funding.

　　因为我们现在的医保筹资水平还很低，从医疗费用的报销方面，患者自己在得病治疗的自付水平还比较高，我们在大病保障方面还要尽力而为，不可能从有限的医保资金当中来支撑我刚才说的那几条，那应该是政府对医院的直接投入。如果对需方和供方两方面的投入都能够到位的话，我们公立医院回归公益性就指日可待了，而且也意味着我们国家的制度设计形成了自身特色。

Because our present health care financing level is still very low,From the aspects of medical reimbursement of expenses,The patient's own in diseases treatment pays level is relatively high,We are a serious illness protection will do my best,Not possible from the limited medical insurance funds to support of I said just now that a few,It should be the government directly into the hospital.If the buyer and the supplier two input can reach the designated position words,We return to public hospital public welfare is on the road,And also means that our country's system design formed their own features.

　　陈竺称，在国际上，有的国家把所有资源全部投入到公立医院去，公立医院免费或者低收费提供服务，但是也有一些弊病，就是效率低、大锅饭，等待住院的时间可以长达几个月，甚至长达十几个月。如果所有资源全部投向需方，那么对供方常常就缺乏一些制约，可能造成诱导医疗消费的倾向。中国采取的是宜需则需，宜供则供，实际上是我们探索有中国特色卫生发展道路的一个重大制度平台。我们希望各级政府能够切实履行举办公立医院的职责，真正体现公益性，让群众得实惠，让医务人员得鼓舞，让党和政府得民心，让卫生事业得发展。(据中国网文字直播整理)

Outlines says,In the world,Some countries put all the resources all into the public hospital,Public hospital free or the low charge to provide services,But there are also some evils,Is low efficiency/mess,Waiting for the hospitalization period can last for several months,Even for ten months.If all all resources to the buyer,So the supplier is often lack of some restriction,May cause induced medical consumption tendency.China is to adopt appropriate is required,Appropriate for is for,In fact is we explore development road with Chinese characteristics health a major system platform.We hope governments at all levels to earnestly implement the held the responsibilities of the public hospital,Embody public welfare,Let the masses have benefits,Let the medical staff have to inspire,Let the party and the government have to morale,Let the health development.(According to China text live finishing)