对话人：卫生部党组书记 张 茅　本报记者　白剑峰

Lady who was:Health BuDangZu secretary zhang bud our reporter BaiJianFeng

  人民健康水平怎么提高 How to improve the level of people's health

　　记者：十八大报告中提出了“提高人民健康水平”，具体内涵和目标是什么？

reporter:Eighteen big report puts forward"Improve the people's health level",The specific connotation and target is what?

　　张茅：“提高人民健康水平”主要包括以下几方面内容：一是要有更加健全的医疗保障体系，人人拥有基本医保，由个人、社会、政府共同筹集医保基金，群众看病可报销，能够看得起病。二是要有更加完善的医疗服务体系，医疗机构布局合理，中西医并重，百姓生了病后可以方便、快捷地到达医院，能够看得上病；同时，要有较好的医疗卫生人才队伍和医疗设备，能够看得好病。三是要有更加可及的公共卫生服务体系，通过健康教育、注射疫苗等传染病防控措施，预防减少或延缓疾病的发生。四是要有更加公平的药品供应保障体系，改革和完善食品药品安全监管体制机制，保障食品安全，使更多的人能够获得价廉而有效的药物，得到更好的治疗。五是要有更加高效的行业监管体制，加强安全质量管理，控制医药费用过快上涨，制止医院盲目扩张，治理医药购销领域商业贿赂，维护人民群众健康权益。

zhang:"Improve the people's health level"Mainly includes the following several aspects:One is to have more perfect medical security system,Everyone has the basic medical insurance,By individual/social/Government jointly raise the medical insurance fund,The masses can submit an expense account to see a doctor,Can respect disease.The second is to have more perfect medical service system,A medical institution layout is reasonable,Both traditional Chinese and western medicine,People born after the disease can be conveniently/Quickly to the hospital,Can KanDeShang disease;At the same time,To have good medical and health personnel team and medical equipment,Can see well disease.3 it is to want to have more accessible public health service system,Through the health education/Vaccinated or other infectious diseases prevention and control measures,Prevention to reduce or delay the occurrence of diseases.Four is to have more fair a system for ensuring drug supply system,To reform and perfect food and drug safety supervision system mechanism,Guarantee food security,Make more people can get cheap and effective drugs,Get better treatment.The fifth is to have more efficient industry regulation system,To strengthen the safety and quality management,Control medical expense rise rapidly,Stop hospital blind expansion,Governance medicine purchase and sale of commercial bribery field,Maintain the health of the people rights.

　　到2020年目标是基本建成覆盖城乡居民的基本医疗卫生制度，实现人人享有基本医疗卫生服务，实现人民群众病有所医。世界卫生组织将人均期望寿命、孕产妇死亡率和婴儿死亡率作为衡量一个国家卫生综合效果和居民健康水平的重要指标。根据国家有关规划要求，到2015年我国人均期望寿命要在2010年基础上提高1岁，到2020年孕产妇死亡率和婴儿死亡率要分别下降到20/10万、10‰。

By 2020 target is the basic covering both urban and rural residents in the basic medical and health system,Realize everyone will have access to basic medical and health services,To realize the people BingYouSuoYi.The world health organization will average life expectancy/The maternal mortality rate and infant mortality rate as a measure of a country health comprehensive effect and residents health level of important index.According to relevant state planning requirements,To 2015 years life expectancy in China in 2010 to improve on the basis of 1 year old,By 2020 the maternal mortality rate and infant mortality rate to drop respectively to 20/10/10 ‰.

　病有所医如何实现 How to realize the BingYouSuoYi

　　记者：我国已编织了全球最大的全民医保网，下一步的目标是什么？

reporter:Our country has woven the world's largest universal coverage network,The next goal is to what?

　　张茅：下一步的目标简单说就是“扩面”和“提标”。一方面进一步扩大覆盖面。到2015年三项基本医保参保率在2010年基础上提高三个百分点，达到98%以上，努力实现应保尽保。另一方面提高保障能力。到2015年基本医保政策范围内住院费用报销比例逐步提高到75%左右，最高支付限额也要同步提高。同时，积极开展城乡居民大病保险，做好与医疗救助制度的衔接，有效提高重特大疾病保障水平，切实减少因病致贫、因病返贫现象的发生。

zhang:The next goal is simple said"Expanding surface"and"DiBiao".On the one hand further extended coverage.By 2015 three basic medical insurance participating insurance rate based on 2010 increased by three percent,Achieve 98% above,Efforts to achieve should defend insurance.On the other hand, improve the support capacity.To 2015 basic medical insurance policy range hospital expense ratio gradually increased to 75%,Highest pay limitation to also want to improve the synchronization.At the same time,Actively carry out a serious illness insurance for urban and rural residents,Do well with the medical salvage system of cohesion,Effectively improve the security level and great disease,To reduce become financially-difficult/The occurrence of the phenomenon of poverty due to illness.

　　记者：如何完善新农合制度？农民工异地医保能否实现？

reporter:How to perfect the new agriculture close system?Migrant workers different medical insurance can be realized?

　　张茅：继续完善新农合制度要从几个方面做出努力，一是增加补助标准，到2015年财政补助标准达到年人均360元以上，住院费用报销比例也将相应提高。二是推动支付方式改革，推行按病种付费、按床日付费、按人头付费、总额预付等支付方式，以利于规范医疗机构服务行为和控制医药费用不合理上涨。三是提高管理服务水平，大力推广新农合“一卡通”，推进医疗费用即时结算；鼓励利用新农合基金购买商业医疗保险，探索商业保险公司参与经办新农合。四是扩大重特大疾病保障范围，优先将发病率高、诊疗技术成熟、费用可控的重大疾病病种纳入保障范围，明显提高报销比例。

zhang:We will continue to improve the system of new farming together to make effort from several aspects,One is to increase subsidies standards,By 2015 financial aid to standard per capita in 360 yuan of above,Hospitalization expense proportion will also increase.The second is to promote the reform of payment,Implementation of the press disease to pay/According to the bed, pay/According to the head pay/The total advance payment, etc,A medical institution for standard service behavior and control medical cost unreasonable rise.Three is to improve the management level of service,Vigorously promote the new agriculture together"card",Promote medical expenses immediate settlement;Encouraging the use of new agriculture close fund to buy commercial medical insurance,Explore the commercial insurance company involved in handling new farming together.The fourth is to expand the scope of protection and great disease,Priority will be high incidence/Treatment technology mature/Cost controlled major disease diseases included in the scope of protection,Obviously increase proportion to submit an expense account.

　　农民工在城乡之间流动时，既面临跨制度、跨地区医保关系转移问题，也可能面临异地就医结算问题。一方面将加强三项基本医保之间的政策衔接，做好不同制度和地区之间医保关系的转移接续。另一方面将加快推进卫生信息化建设，实现异地就医信息和医保资金的全国联网。目前，全国和各地都正在建设新农合信息系统，在建成的区域内已初步实现数据的互联互通。

Peasant workers in the flow between urban and rural areas,Are faced with both cross system/The problem of the transfer of medical insurance relations across the region,Also may face different medical settlement problem.On the one hand will strengthen three basic medical insurance policy between cohesion,Do different system and the area between the transfer of medical insurance relationship succeeded.On the other hand will accelerate the health information construction,Realize different medical information and medical insurance fund of the national network.At present,The national and local are construction of new farming together information system,Built in the area is preliminary already realize the data interconnection and interflow.

　　记者：建立重特大疾病保障和救助机制的具体措施有哪些？

reporter:Establish and great disease protection and rescue mechanism concrete measures what?

　　张茅：建立重特大疾病保障和救助机制主要举措是建立“三道保障线”。第一道保障线为常规保障，即三项基本医保按住院有关政策进行常规报销；第二道保障线为大病保障，即常规报销后，对农村儿童白血病、先天性心脏病等20种重大疾病先由新农合按照不低于70%的比例进行补偿，对补偿后个人自付超过大病保险补偿标准的部分，再由大病保险按照不低于50%的比例给予补偿；对于其他重大疾病，在常规报销后需个人负担的合规医疗费用，由大病保险按照不低于50%的比例给予补偿。第三道保障线为医疗救助，即通过以上两个渠道报销后，属民政救助对象的，按医疗救助政策给予救助报销。

zhang:Establish and great disease protection and rescue mechanism mainly measures is established"Three way security".The first security for conventional security,That is three basic medical insurance according to the relevant policies in routine to submit an expense account;The second way to guarantee security of a serious illness,That is after conventional submit an expense account,For rural children leukemia/Congenital heart disease and other 20 kinds of major disease first by the new agriculture close according to not less than 70% of the compensation,After the compensation for personal self pay more than a serious illness insurance compensation standard part,Again by a serious illness insurance according to not less than 50% of the compensation;For other major disease,In conventional after submit an expense account to individual responsibility medical treatment cost of compliance,From a serious illness insurance according to not less than 50% of the compensation.The third way security for medical assistance,That is, through the above two channels after submit an expense account,Belong to civil administration rescue object,According to medical assistance policy to give aid to submit an expense account.

　看病难、看病贵如何解决 See a doctor difficult/The doctor your how to solve

　　记者：县级公立医院改革难点何在？取消以药补医能否实现？

reporter:Public hospital reform what difficulties at or above the county level?Cancel to medicine complement medical can be realized?

　　张茅：目前，县级公立医院改革难点主要体现在：“以药补医”机制尚未完全打破，人事分配制度不尽合理，医院管理水平有待提高，医院绩效考核仍不完善，调动医务人员积极性的有效措施还未完全到位等。

zhang:At present,Public hospital reform difficulties at or above the county level are mainly embodied in:"In medicine for medical"Mechanism has not yet completely break,Personnel distribution system is not rational,To improve hospital management level,Hospital performance evaluation is still not perfect,To mobilize the enthusiasm of the medical staff effective measures are not completely reach the designated position, etc.

　　取消药品加成是彻底破除“以药补医”机制的一个突破口。目前，全国有600多个县和北京、深圳等试点城市的公立医院正在进行取消药品加成的探索，同时完善补偿机制，医院减少的收入主要通过加大财政补助力度、调整医疗服务价格、推行医保支付制度改革等途径予以补偿。

Cancel the drug addition is completely break"In medicine for medical"The mechanism of a breakthrough.At present,There are more than 600 national county and Beijing/Shenzhen and other pilot city of public hospital is to cancel the drug addition of exploration,At the same time perfect compensation mechanism,The hospital to reduce income mainly through increasing financial aid efforts/Adjustment of medical service prices/Implementation of the medical insurance payment system reform the way such as compensation.

　　记者：基本药物制度如何巩固？何时能够覆盖城市大医院？

reporter:Essential drugs system how to consolidate?When to cover the city big hospitals?

　　张茅：通过前三年的努力，基本药物制度在政府办基层医疗卫生机构实现了全覆盖，但也面临着实施范围不广、目录品种不全、生产和保障不足等问题，还需要进一步落实和巩固。一是根据各地基本药物实际使用情况，进一步完善基本药物目录，适当增加慢性病、重大疾病和儿童用药品种；二是继续坚持以省为单位网上集中采购，落实招采合一、量价挂钩、双信封制、集中支付、全程监控等采购政策；三是有序推进村卫生室实施基本药物制度，引导和鼓励其他医疗机构优先使用基本药物；四是提高基本药物生产和供应保障能力，对一些用量小临床必需的基本药物实行招标定点生产。

zhang:Through the first three years of hard work,Essential drugs system in basic medical and health institutions and government realized the full coverage,But also is facing a scope of implementation not widespread/Directory variety is not complete/Production and security problems,Also need to further implement and consolidated.It is according to the actual use of all basic drugs,Further improve the basic drug catalogue,Appropriate increase chronic disease/Major disease and children drug varieties;The second is to continue to adhere to the province as a unit centralized purchasing online,Carry out and recruit mining/Quantity price hook/Double envelope system/Centralized payment/The whole monitoring and purchasing policy;The third is orderly propulsion village clinic implementation of essential drugs system,Guide and encourage other medical institutions preferred use basic drugs;Four is to improve basic drug production and supply support capacity,For some small amount of clinical necessary basic drug implement bidding sentinel production.

　　国家基本药物目录包括两部分，分别是基层医疗卫生机构配备使用部分和其他医疗机构配备使用部分。2009年我国发布的第一版基本药物目录就是基层医疗卫生机构配备使用部分，同时要求其他各类医疗机构也要按规定比例使用基本药物。目前我们正在研究制定适用于所有医疗机构的基本药物目录，目录公布后，将会对二级以上医疗机构配备使用基本药物提出具体要求。

The national essential drug list includes two parts,Respectively is basic medical and health institutions equipped with the use of and other medical institutions are equipped with the use of.In 2009, issued the first edition of essential drugs list is basic medical and health institutions equipped with the use of,At the same time request other all kinds of medical institutions will to scale use basic drugs.Now we are to study and formulate applies to all medical institutions of essential drugs list,After the release of a directory,Will the second class above medical institutions to use drugs with basic put forward specific requirements.