济宁新农合支付方式由后付变总额预付 Jining new farming together after payment by pay total change in advance

支付改革，抑制过度医疗？ Payment reform,Inhibiting excessive medical?

　　关于济宁新农合基金的种种猜测，随着济宁市卫生局、财政局联合下发的一份文件而引发。在不少医院看来，这份《关于全市新型农村合作医疗支付方式改革的指导意见(试行)》把新农合基金的支付方式由后付费变为了预付，进行总额控制，季度超支20%以上部分，将由医院自付承担。“新农合基金是不是没钱了？要不怎么会控费？”在猜测和质疑声中，突如其来的控费，令医院措手不及。济宁一家二级医院的院长甚至直言，“医”与“保”本来就是一种对立关系，这种控费措施，只是将基金的运行风险，转移到医院身上而已。

About jining new farming close fund rampant speculation,Along with the jining city health bureau/Finance bureau jointly issued a document and cause.In many hospital looks,this[About the new rural cooperative medical payment reform direction(trial)]New farmers joint fund payment after the pay into the prepaid,Total amount control for,Quarter overspend 20% above part,Will the hospital out-of-pocket bear."New farmers joint fund is not money?Or how can control fee?"In the speculation and misgivings about,The sudden control fee,Make hospital unprepared.Jining a secondary the head of the hospital and even the truth,"medical"and"insurance"Originally a kind of opposite relationship,This control fee measures,Just will fund operation risk,Transfer to the hospital's body.

花钱的烦恼 Money troubles

　　10月10日，济宁兖州新农合管理办公室内，会计赵瑞低头按着桌上的计算器感慨，从来没有像今年这么紧张、这么忙碌过，“钱花得特别快。”

On October 10,,Jining yanzhou new farming joint management office,Accounting ZhaoRui down according to the calculator regrets,Never like this year so nervous/So busy over,"The money was particularly fast."

　　感觉到基金压力的并非只有兖州。来自济宁市卫生局的数据表明，2012年，当地新农合筹资水平提高到每人每年300元，比2011年提高了25%。但即便如此，依然不能满足新农合资金使用增长的速度，2012年1—5月份，济宁市新农合住院病人同比增加了近六成。

Feel the fund pressure not only yanzhou.From jining city health bureau data shows,In 2012,,The local new farming joint funding level increased to 300 yuan per person per year,More than 2011 increased by 25%.But even so,Still can not meet the new agriculture joint capital use the speed of growth,2012 1-5 months,Jining new farming combined hospital patients increased almost sixty percent year-on-year.

　　在分析住院病人出现“井喷”增长的原因时，济宁一家医院的院长表示，除了城乡居民医保覆盖面增加、住院补偿比例提高和门诊统筹试点等制度的不断完善，居民收入水平提高等原因外，已经在全市推广的“先看病后交钱”政策、直接刺激了居民的医疗消费，原来受到压抑的医疗需求得以释放。

On the analysis of hospital patients appeared"blowout"When the reasons for the growth of the,Jining a the head of the hospital said,In addition to urban and rural residents increased medical insurance coverage/Hospital compensation ratio improve and outpatient service to plan as a whole the pilot program of the continuous improvement of the system,The income level of resident reason such as improve outside,In the city has been extended"After the first doctor make money"policy/Direct stimulation of the residents' medical consumption,The original repressed needs of medical treatment to release.

　　除了患者人数的增加，平均住院费用也水涨船高。济宁市卫生局统计显示，今年前五个月当地市级医疗机构次均住院费用增长率达到了15.1%，县级医疗机构次均住院费用增长率达到13.53%。

In addition to the increasing number of patients,The average hospitalization cost is rising.Jining city health bureau statistics show,The first five months of this year the local municipal medical institutions second all hospital cost growth rate reached 15.1%,Medical institutions at or above the county level are time hospitalization cost growth rate reached 13.53%.

　　多重因素影响下，前五个月济宁全市范围内新农合资金的使用已达全年的51.34%。半年过后，个别县市区已经用掉了超过60%的基金。

Under the influence of multiple factors,In the first five months of jining within the scope of the new farming together in the use of funds has amounted to 51.34% of all the year round.After half a year,Individual wing already used up more than 60% of the fund.

　　一份兖州市定点医疗机构记账凭证显示，今年1-5月份，兖州市共支付新农合基金4913万余元。而据赵瑞介绍，2012全年新农合基金收入预计为1.08亿左右。兖州市新农合管理办公室主任孟宪伟向记者表示，“从理论上测算，如果不控费的话，将物价增长、医疗消费增长等因素考虑进去，年底可能产生两千万的基金超支。”

A YanZhouShi fixed-point medical institutions evidence of charge to display,In may this year 1 -,YanZhouShi common pay for the new agriculture close fund more than 49.13 million yuan.And according to ZhaoRui is introduced,2012 the new agriculture close fund income is expected to about 108 million.YanZhouShi new farming joint management office director MengXianWei told reporters,"From the theoretical calculation,If you don't control fee words,Will price growth/Medical consumption growth factors into consideration,The end of the year may produce twenty million fund overspending."

　　自2004年被省政府列为新农合试点城市的兖州，截至2011年累计结余新农合基金1020.57万元。如果今年不采取措施，一旦产生透支，可能吞没此前多年的累计结余，并产生规模不小的赤字。

Since 2004 the provincial government as new farming together pilot city of yanzhou,By the end of 2011 accumulated balance new farming close fund 10.2057 million yuan.If measures are not taken this year,Once produced overdraft,May engulf after many years of accumulated balance,And produce large deficit.