【对话背景】 [Dialog background]　　

　　医疗卫生体系是一个复杂系统，解决问题不能“头痛医头、脚痛医脚”。在国家新一轮医改提出的“保基本、强基层、建机制”9个字的基础上，上海又结合自身实际，提出了“打基础、管长远、可持续”这9个字的原则。如何建立医疗卫生事业的可持续发展机制？上海市卫生局局长徐建光的观点，可以为我们带来更多启示。

Medical and health system is a complicated system,Can't solve the problem"Instant gratification/JiaoTongYiJiao".In a new round of reform of the state is put forward"The basic/Strong base/Built mechanism"On the basis of nine words,Shanghai and its own reality,Puts forward the"ground/Tube in the long run/sustainable"The nine principles of the word.How to establish the sustainable development of medical and health services mechanism?The surgeon general XuJianGuang point of view,Can bring us more inspiration.

　“花钱买机制”推动医改进行 "Buy mechanism"Promote reform in

　　本报评论部：上海新医改方案中，多项指标均高于国家标准，领全国之先。上海何来这样的底气？

Our PingLunBu:Shanghai new medical reform scheme,A number of indicators are higher than the national standard,Brought the first national.Shanghai no such style?

　　徐建光：这是一个态度和观念问题。首先，医疗卫生发展和百姓密不可分，政府要高度重视，这是人民群众最关心、最直接、最现实的利益问题。满足群众的医疗卫生服务需求，需要完善医疗资源配置，提高技术水平和服务能力；需要加大医疗保障力度，提高医疗保障水平，这必然需要一定的财力保障。今天，上海有条件、也更有责任把医疗卫生工作摆到更加突出的位置。

XuJianGuang:This is an attitude and concept.First of all,Medical and health development and the people are inseparable,The government should attach great importance to,This is the people most concerned about/The most direct/The most realistic interests problem.To meet the needs of medical and health services,Need to perfect medical treatment allocation of resources,Raise the level of technology and service capacity;Need to increase the medical security efforts,Improve the medical security level,This will need some financial security.today,Shanghai conditional/And more have the responsibility to the medical and health work be placed on a more prominent place.

　　本报评论部：这是否意味着，足够的财力支撑是医改能有效推进的第一条件？

Our PingLunBu:Does this mean that,Enough financial support can effectively promote reform, is the first condition?

　　徐建光：医改需要花钱，但并非花钱就会有好效果。财力是医改必要条件之一，有了财力支撑，才能发展医疗卫生事业、提升医疗技术、提高医疗保障水平。但更重要的仍然是建立科学的体制机制，用制度保障人人享有基本医疗卫生服务，用制度落实政府各部门的责任，用制度规范医疗卫生服务，调动各方积极性，为实现科学发展提供制度保障。可以这么说，上海医改是“花钱买机制”。

XuJianGuang:Medical need money,But not spend money there will be a good effect.Financial reform is one of the necessary conditions,The financial support,To the development of medical and health services/Improve medical technology/Improve the medical security level.But more important still is to establish a scientific system mechanism,Use system guarantee everyone will have access to basic medical and health services,With the system implement the responsibility of the government departments,Use system to standardize medical and health services,Mobilize all enthusiasm,To achieve scientific development provides the system safeguard.Can say so,Shanghai medical reform is"Buy mechanism".

　把握改革力度量力而行 Grasp the reform does what one can

　　本报评论部：《中共中央、国务院关于深化医药卫生体制改革的意见》，强调“坚持公平与效率统一”，如何理解这一点？

Our PingLunBu:[The central committee of the communist party/The state council on deepening the reform of medical care system views],emphasize"Adhere to the fairness and efficiency unification",How to understand this?

　　徐建光：强调公平，是因为健康权是公民的基本权利，基本医疗卫生服务不能因为个人的身份差别、财富多寡而影响基本权利的享有。强调效率，是因为不断增长的卫生服务需求和有限的卫生资源之间存在矛盾，必须提高效率，控制浪费，才能最大限度地满足群众的医疗卫生需求。

XuJianGuang:Emphasizes on fair,Because health is the basic right of citizens,Basic medical and health services can't because of the personal identity difference/How much money affect basic right to enjoy.Emphasize efficiency,Because of the growing health service demand and limited health resources there is a conflict between,Must improve efficiency,Control waste,To the maximum meet the health requirements.

　　实现公平和效率兼顾，主要靠一系列的制度设计。涉及卫生服务体系如何构建，医保参保制度、待遇水平、支付制度如何设计，医疗服务管理如何规范等。

Fairness and efficiency of give attention to two or morethings,Mainly by a series of system design.In health service system how to build,Medical insurance ginseng protect system/Treatment level/Payment system how to design,Medical service management how to standardize, etc..

　　本报评论部：您认为，上海医改的关键词是什么？

Our PingLunBu:Do you think,Shanghai medical keywords is what?

　　徐建光：国家医改提出了“保基本、强基层、建机制”的原则，上海还要加上“打基础、管长远、可持续”这9个字。

XuJianGuang:National reform put forward"The basic/Strong base/Built mechanism"principle,Shanghai plus"ground/Tube in the long run/sustainable"The nine words.

　　“打基础”，就是要在深化改革的同时，还要夯实资源配置、人才队伍、信息化管理等基础性工作；“管长远”，就是要把握改革的正确方向，建立符合未来发展的基本制度和体系框架，为医疗卫生事业的长远发展奠定基础；“可持续”，就是要把握改革的力度，量力而行。不盲目超越，改革就经得起时间的检验。

"ground",Is to deepen the reform at the same time,To tamp the allocation of resources/Talent team/Information management basic work;"Tube in the long run",Is to grasp the correct direction of the reform,Establishment conforms to the future development of the basic system and the system framework,For the long-term development of medical and health services lay the foundation;"sustainable",Is to grasp the reform,Does what one can.Don't blindly beyond,Reform will withstand the test of time.

　　本报评论部：好的制度设计可以事半功倍。如何让制度设计更科学？

Our PingLunBu:Good system design can be twice the result with half the effort.How to make the system design more scientific?

　　徐建光：这需要推进资源整合利用、建立有效的分工合作机制。上海把组建区域医疗联合体、建立家庭医生制度作为两个主要抓手，对卫生服务体系进行重构。

XuJianGuang:The need to promote resources integration and utilization/To establish an effective division of labor cooperation mechanism.Shanghai to set up regional medical association/A family doctor system as two main gripper,To reconstruct the health service system.

　　最近，我们正在为全科医生打造“政策包”，在薪酬、学术成长空间、申请科研基金等方面进行倾斜，吸引更多优秀人才投身到社区医疗事业，逐渐吸引百姓就医下沉。

recently,We are for general practitioners make"Policy package",In the salary/Academic space to grow up/Apply for scientific research fund and so on tilt,To attract more talents join in community medical career,Gradually attract people go to a doctor sink.

　公开透明减小改革阻力 Transparent reduce resistance to reform

　　本报评论部：上海医改方案公布之前曾经征询过市民意见，并做了适当修改。如何看待公开透明对医改的意义？

Our PingLunBu:Shanghai medical scheme before published once sought public feedback,And make the appropriate changes.How to treat the significance of transparent to cure?

　　徐建光：医改政策与人民群众的利益密切相关，必须保障群众的知情权和参与权，让广大人民群众参与、了解和理解改革，进而支持改革。公共政策制定和实施过程的公开透明，既是政府职能转变的体现，更是改革顺利实施的关键环节。

XuJianGuang:Medical reform policy and closely related to the people's interests,Must guarantee the right to know and participate,Let the masses to participate in/Know and understand the reform,And then to support the reform.Public policy formulation and implementation process of the transparent,Is the embodiment of the transformation of government functions,The reform is the key link of smooth implementation.

　　上海在制订医改方案的过程中，始终坚持公开透明，听取各方面意见。实施过程中，既宣传进展和成效，也不避讳问题，让市民群众树立科学的就医理念。我们以往有些“拍脑袋”、脱离现实条件的医改举措，也是造成今天“看病难、看病贵”状况的原因之一。但纠正这些问题，只宜“软改革、软着陆”，只有让百姓感受到医改带来的实惠，他们才会消除疑虑，支持进一步改革。

Shanghai in making the process of medical reform scheme,Always adhere to the transparent,Listen to the opinions.Implementation process,Both propaganda progress and results,Also not afraid problem,Let the people set up the scientific concept of medical treatment.We used some"Take head"/From the practical condition of the reform measures,Is also causes the today"Difficulties in getting/The doctor your"One of the reasons for the situation.But to correct these problems,Only appropriate"Soft reform/Soft landing",Only let people feel reform brings benefits,They will eliminate the doubts,Support for further reform.

　　本报评论部：您曾说过，医改已经进入“深水区”。未来改革重点在哪里？

Our PingLunBu:You once said,Reform has entered into"Deep water area".The future reform key in where?

　　徐建光：下一步，上海将重点推进公立医院改革，尤其是体制机制方面的改革。以破除“以药补医”为切入口，推进医药分开机制、药品采购供应机制、投入补偿机制、医保支付机制、监管评价机制、医务人员薪酬机制等综合改革。

XuJianGuang:The next step,Shanghai will focus on promoting reform of public hospitals,Especially the system mechanism reform.To break"In medicine for medical"The related,Promote medical separate mechanism/Drug purchasing and supply mechanism/Into compensation mechanism/Medical insurance payment mechanism/Supervision evaluation mechanism/Medical workers compensation mechanism, and other comprehensive reform.

　　“以药补医”是上世纪50年代建立的补偿公立医院的机制，现在看来带来很多弊端。下一步一定要把这个机制改掉。目前公立医院扩建、购买大型设备、人力成本等都由政府来补偿，这对财政是很大挑战。与此同时，还要充分调动医务人员积极性，改善执业环境，提高劳务价值。群众得实惠，医患关系才能更和谐。(记者 王有佳整理)

"In medicine for medical"Is the 1950 s to establish compensation mechanism of public hospitals,Now it seems to bring a lot of disadvantages.The next step must get rid of this mechanism.At present the public hospital/To buy large equipment/The human cost are made by the government to compensate,The finance is a big challenge.meanwhile,To fully mobilize the enthusiasm of medical personnel,Improve practice environment,Improve labor value.Enrich the,The doctor-patient relationship can be more harmonious.(Reporter WangYouJia finishing)