广州在本次医保条例立法听证中，首次提出三大医保制度整合互济，一石激起千层浪 Guangzhou in the medical insurance regulations of legislative hearing,First put forward three medical insurance system integration each other aid,A stone arouse thousand layer wave

　　

是“富帮穷”还是要“劫富济贫”？ is"Rich help poor"or"man"?

　　在“新医改”还未明确三种医保如何整合之时，广州在本次医保条例立法听证中，首次提出要打破职业界限，在制度、缴费、待遇未统一情况下，将城镇职工医保、城镇居民医保和新农合基金“统筹使用、统一核算”，用职工医保基金的结余，填补居民医保不足，以实现不同医保制度的整合和互济。

in"The new medical reform"Is not clear how to integrate the three medical insurance,Guangzhou in the medical insurance regulations of legislative hearing,This paper proposes for the first time to break professional boundaries,In the system/capture/Treatment is not unified cases,The medical insurance for urban workers/Medical insurance for urban residents and new farming joint fund"Use as a whole/Unified accounting",The medical insurance fund balance with the worker,Fill the residents lack of medical insurance,In order to realize the integration of different medical insurance system and each other.

　　对于这种方式的医保制度“整合”，一石激起千层浪。有听证代表表示，这是体现“富帮穷”社会美德。有代表则直言这一政策意味着在“劫富济贫”，该行为违法。专家则建议，目前三大医保制度并举情况下，制度之间衔接转换、消除身份差异，才是关键。

For this kind of medical insurance system"integration",A stone arouse thousand layer wave.A hearing on behalf of the said,This is reflected"Rich help poor"Social virtues.A representative is the truth this policy means that in"man",This action is illegal.Experts suggest,At present three medical insurance system and circumstance,System connection between conversion/Eliminate identity difference,Is the key.

　　

A制度不融合 A system integration

　　

把钱都放在一起使用的医保制度整合，靠谱否？ Put the money together the use of medical insurance system integration,By spectrum no?

　　广州此次医保条例立法听证，提出了一条不同医保制度整合“新路径”：制度差异搁置一边，先打破职业差异，将三项制度的钱放在一起使用。医保条例草案中称之“统筹使用、统一核算”。

Guangzhou the medical insurance regulation legislative hearing,Put forward a different integration of medical insurance system"The new path":The system differences aside,First break professional differences,Will the three systems use money together.The medical insurance bill said"Use as a whole/Unified accounting".

　　大部分听证代表表示支持这个做法，少部分人提出了质疑。

Most of the hearing on behalf of voiced support for the practice,A few people questioned.

　　听证代表、广州医生陈全福是少数的质疑者，他认为不考虑制度合并、仅仅将三项制度的钱放在一起用，没有任何益处，因为居民医保亏空公众本无须考虑，是政府财政填补。三项制度的钱放在一起用将产生诸多更加难以解决的社会问题。

Hearing representatives/Guangzhou doctor ChenQuanFu is one of the few who questioned,He thinks not consider system merger/Only three system will be the money together with,No profit,Because residents medical insurance deficit public this does not need to consider,Is the government fiscal fill.The system of three money together with will produce many more difficult to solve social problems.

　　“由于制度不统一，原来不参保的人，还是不参保。钱放在一起用，职工医保由于将钱分给了居民医保，职工的待遇提升跟不上去，将会造成一些人放弃参保，最终医保体系压力更大。”

"Due to the system is not uniform,Didn't join the people,Or not ginseng.Money together with,The worker medical insurance because of money among the residents health care,The worker treatment to improve couldn't keep up with,Will cause some people to give up ginseng protect,Final medical insurance system more pressure."

　　听证代表、退休职工郑涛也有类似担忧，三项制度钱放在一起用，居民医保亏了由职工医保补，“在当前职工退休工资低下，很多企业退休职工看不起病的情况下，此举必伤退休职工的心，会一石激起千层浪，影响职工医保的前途。建议把资金不足的居民医保和公费医疗统筹使用，有利于构建和谐社会。”

Hearing representatives/Retired worker fun also have similar concerns,Three systems with money together,Medical residents lost by worker for medical insurance,"In the current employee retirement pay is low,A lot of enterprise retired worker look down on disease cases,This will hurt the heart of the retired worker,Will a stone arouse thousand layer wave,Affect the future of health care workers.Suggested that the fund shortage of residents medical insurance and medical treatment use as a whole,Build up a harmonious society."

　　有专家认为，三项制度应该分别发展，待户籍制度改革后，三项制度再合并。

Some experts think the,Three system should be separate development,After the reform to the household registration system,Three system to merge.

　　也有专家提出，三大医保制度首先应结束各地不一致，实现制度在省的层面一致，然后新农合和城镇居民医保合并，最后形成类似东莞目前的单一医保制度。中山大学社保专家申曙光等人则认为，在城市化较高的地区，应首先尝试推进新农合和居民医保一体化。在条件具备的情况下，再考虑三大制度整合。

Also have experts,The first three medical insurance system should be around the end do not agree,Realizing the system at the provincial level consistent,Then the new agriculture close and medical insurance for urban residents merger,The final shape similar to the dongguan current single medical insurance system.Sun yat-sen university, such as social security experts ShenShuGuang regarded,In the urbanization of high area,Should first try to push the new agriculture close and residents health care integration.In the conditions of the case,Consider three big system integration.

　　

B整合不合法 B integration illegal

　　

居民医保缺口由职工医保弥补是富帮穷，还是“劫富济贫”？ Residents health gap by worker medical insurance is for the rich to help the poor,or"man"?

　　广州此次将钱放在一起使用的医保制度整合模式，带来最大争议的是：职工医保拿钱给居民医保，到底合不合理。参与听证的代表进行了激辩：一些人认为这是“富帮穷”，一些人认为这是政府“劫富济贫”。

Guangzhou will be the money together use integration mode of medical insurance system,Bring the most controversial is:The worker medical insurance and medical insurance money to people,The reasonable or unreasonable.To participate in the hearing representatives of the excitation debate:Some people think it is"Rich help poor",Some people think that this is the government"man".

　　广州职工医保基金结余率偏高，资金使用率低的问题一直较为突出，结余率约在四成。这个数据远远高于世界各国医保10%的结余率和商业医保10%左右的风险提留金的惯例。如何使用起这笔巨额结余资金，是广州医保需直面的一个问题。

Guangzhou worker medical insurance fund balance rate on the high side,Fund the low utilization rate has been more prominent,Balance rate is about forty percent.This data is far higher than the countries all over the world medical insurance 10% of balance rate and the risk of commercial medical insurance 10% tiding over gold practice.How to use up the huge surplus funds,Guangzhou medical insurance should be face to face with a problem.

　　与此同时广州城乡居民医保基金却显不足。已经统计出来的数据显示，广州居民医保2009年亏1.3个亿，2010年、2011年预计亏1.6个亿，2012年预计缺口超过1.8个亿。合计起来广州居民医保预计已经亏近5个亿。在医保基金没有统筹使用之前，广州市人社局也在为弥补这个缺口，想出了上涨居民医保缴费的办法，一场讨论之后，上涨未获实现。

At the same time guangzhou urban and rural residents medical insurance fund is obviously insufficient.Have of the statistics of data display,Guangzhou residents health 2009 kui 1.3,In 2010,/In 2011 is expected to kui 1.6,In 2012 is expected to gap of more than $1.8.Total up guangzhou residents medical insurance is expected to have kui nearly 5.In the medical insurance fund not to plan as a whole before use,Guangzhou city club board also in to fill the gap,Come up with the rising medical residents pay cost method,After a discussion,Rise has not been realized.

　　虽然市人社局强调，根据国家规定，居民医保基金的缺口，由政府财政掏钱填补，但目前政府财政还未掏钱弥补这个缺口。羊城晚报记者从听证代表处获悉，一旦职工医保和居民医保统筹使用的条例通过后，居民医保的缺口将由职工医保基金弥补，政府无须再为居民医保的缺口垫钱。这也是有关方面力推基金统筹使用的一个原因。

Although the city people emphasize social bureau,According to the provisions of the state,Residents of the medical insurance fund gap,The government pays to fill,But the government has not paid to fill this gap.The yangcheng evening news reporter from hearing of representative office,Once the worker medical insurance and medical insurance as a whole is the law of the people use after,Medical residents of the gap will by worker for the medical insurance fund,The government needn't for residents health care gap pad money.This is the plan as a whole fund use push one of the reasons.

　　“医保基金作为公众财产，和税收一样，是政府进行二次分配的手段，天生具备‘劫富济贫’的性质。”听证代表、工程师马俊表示。

"The medical insurance fund as public property,And tax as,For a government secondary allocation means,Naturally have‘man’Properties of."Hearing representatives/Engineer majun.i said.

　　市人社局医保处处长张学文表示，立法规定职工医保掏钱补足居民医保基金不足，是“富帮穷、强帮弱”。

City people club medical insurance bureau marshal zhang said,Legislation worker pay medical insurance complement residents medical insurance fund shortage,is"Rich help poor/Strong help weak".

　　“多数发达国家和地区已建立未成年人、老人和无业人员等人群免费医保制度，完全依赖工薪阶层缴费和政府税收等方式筹集基金。实质上就是由有经济收入的人群保障上、下两代人和社会弱势群体。”张学文表示，“这是任何国家和地区保障全体社会成员基本医疗需求的有效方式，也是社会文明进步的具体体现。

"Most of the developed countries and regions have established minors/The old man and unemployed people, such as free medical insurance system,Completely depend on the working class pay cost and government tax and other way to raise funds.In essence is the economic income population security/The next two generations and the social vulnerable groups."Zhang said,"This is any countries and regions all the members of the society guarantee basic medical needs of effective way,Is the embodiment of social civilization and progress.

　　反对政府动手“劫富济贫”的听证代表则认为，该行为违法。“让职工医保给居民医保买单，采取摊薄职工医保参保人的福利的方式进行填补，构成非法的财富再分配。”律师曾报春认为，这种“劫富济贫”方式是违法的，因为《社保法》第64条明文规定：社会保险基金专款专用，任何组织和个人不得侵占或者挪用。“一句话，用职工医保基金去补充居民医保基金之不足，可构成该条款所指的侵占挪用，更是侵犯了职工医保参保人的共同权益。”

Against the government to"man"On behalf of the hearing is considered,This action is illegal."Let a worker health care to the residents to pay medical insurance,Take diluted worker medical insurance ginseng protect the welfare of the people the way of fill,Unlawful wealth redistribution."Lawyers had that make a spring,this"man"It is illegal to way,because[Social security law]Article 64 expressly provided:Social insurance fund special fund is special,No organization or individual may occupy or divert."word,With the worker medical insurance fund to supplement the shortage of residents medical insurance fund,Can form the clause referring to prevent their misuse,But also violated the worker medical insurance ginseng protect people's common interests."

　　

C互通是关键 C communication is the key

　　

让参保人员能够在居民医保、职工医保以及新农合之间有一个转换通道 Let ginseng protect personnel to medical residents/Worker health and new farming joint between one conversion channel

　　申曙光等专家此前撰文指出：目前三大医保制度实现了制度全覆盖，但还未能有效解决百姓“看病难、看病贵”问题。因此，为实现真正意义上的全民医保，加快三大制度的“衔接与整合显得尤为必要，建立三大制度之间的转换通道，使医保制度能够适应人们工作岗位、身份变动频繁的特点，让参保人员能够在居民医保、职工医保以及新农合之间转换。”

ShenShuGuang experts pointed out that previous articles:At present three medical insurance system to realize the system complete coverage,But has failed to effectively solve the people"Difficulties in getting/The doctor your"problems.so,For a true sense of universal coverage,To speed up the three big system"Cohesion and integration is necessary,Establish three big system conversion between channel,Medical insurance system that can adapt to the people work/The characteristics of identity change frequently,Let ginseng protect personnel to medical residents/Worker health and new farmers convert between together."

　　“针对三个医保制度带来的不公平问题，只能通过社会劳动生产能力的提高、经济实力的增加，逐渐推进。”听证代表、医生陈全福说，不能通过仅仅将三者的钱放在一起用，来解决三种医保不均衡问题。

"According to the three medical insurance system bring unfair problem,Only through the improvement of social labor production capacity/The increase of economic strength,Gradually promote."Hearing representatives/The doctor said ChenQuanFu,Not only will the three money together with,To solve the three medical insurance disequilibrium problem.

　　“统一核算职工医保基金和城乡居民医保基金并无不当。但是在设计统筹使用制度的过程中可能还要考虑统一参保待遇、就医管理、基金管理等相关问题，真正清除参保身份带来的差异，体现社会公平。”听证代表、教授葛自丹提出。(记者 杨辉 黄丽娜)

"Unified accounting worker medical insurance fund and medical insurance fund all urban and rural residents and when.But in the design of the system as a whole to use in the process of unified treatment may also want to consider the ginseng/Medical management/Fund management and other related problems,Really clear ginseng protect identity brings difference,Reflect social justice."Hearing representatives/Professor ge since Dan put forward.(Reporter Yang hui HuangLiNa)