新华视点：取消公费医疗，为何困难重重？ Xinhua viewpoint:Cancel the medical treatment,Why difficult?

　　日前，南京市政府召开新闻发布会宣布，全市20多万国家工作人员将于2013年取消公费医疗。这一消息在媒体引发了有关公费医疗改革的热议。

a,Nanjing municipal government held a press conference to announce,The more than twenty state functionaries in 2013 will be cancelled to public health care.The news caused in the media about the reform of the medical treatment of hot debate.

　　公费医疗与城镇职工基本医保能否真正并轨，取消公费医疗能否推动医疗福利的公平化进程？针对这些问题，新华社“新华视点”记者采访了有关专家及业内人士。

Medical treatment and urban employee basic medical insurance can truly and,Cancel the medical treatment can promote medical benefits the impartiality of the process?In the light of these problems,The xinhua news agency"Xinhua viewpoint"The reporter interviewed experts and people in the industry.

　　

公费医改艰难，14年仍未完成 Fee reform difficult,14 years is still not completed

　　公费医疗是指国家通过医疗卫生部门，向国家工作人员提供免费医疗及预防服务的制度，经费主要来源于各级财政。它与企业职工劳保曾共同组成计划经济年代的城镇医疗福利体系。

Medical treatment is to show the country through the medical and health departments,To state personnel to provide free medical care and prevention service system,Funds mainly come from departments at all levels for finance.It and enterprise worker labor was composed of the planned economy s urban medical welfare system.

　　我国公费医疗改革的取向是取消公费医疗，将国家工作人员与城镇职工的医保待遇纳入统一管理体系。这有利于增加医保资金覆盖面，提高医保资金使用效率，可谓是利国利民。

Our country public health care reform is to cancel the orientation of the public health care,The state personnel and medical insurance for urban workers in the treatment of unified management system.This is helpful to increase the medical insurance fund coverage,Improve the medical insurance fund use efficiency,It may be said is benefits the country and the people.

　　由于国家工作人员的医保待遇相对较高，而城镇职工的医保待遇相对较低，因此取消公费医疗的改革一直步履蹒跚。

As the working staff of the relatively high medical treatment,And the town worker medical treatment is relatively low,Cancelled public health services reform has been rolled up.

　　来自广州人力资源与社会保障局的资料显示，2011年，广州市6万多名国家工作人员，公费医疗花费近1.5亿元；而该市258万多名普通城镇居民，基本医疗保险补助资金为1.3亿多元。也就是说，政府财政为国家工作人员支付的人均医疗费用，远远大于普通的城镇居民。

From guangzhou human resources and social security bureau data shows,In 2011,,Guangzhou more than 60000 state personnel,Medical treatment cost nearly 150 million yuan;And the city more than 2.58 million common urban residents,The basic medical insurance subsidy funds for 130 million multivariate.that,Government financial for state personnel pay medical treatment cost per capita,Than ordinary urban residents.

　　中国人民大学劳动人事学院仇雨临教授说，从国家财政支出看，如此沉重的公费医疗既不公平、也不经济。有人形容公费医疗是喂不饱的怪兽，吞噬着巨额财政资金。

Chinese people's university professor in the institute of labor and personnel QiuYu said,From the national fiscal spending to see,So heavy medical treatment is not fair/Also not economic.Some people describe medical treatment is not full feed the monster,Devour the huge financial capital.

　　北京市公务员陈卫华介绍，过去的公费医疗只能到单位定点的北大医院就医，还要先垫付医疗费用，之后才能凭票报销。“有时，开车的油钱都比药费高。取消公费医疗后，所有城镇职工医保的定点医院都可以就医，方便了不少。”

Beijing civil servants ChenWeiHua is introduced,The past medical treatment only to the designated unit of Peking University hospital,Also first disbursements medical costs,Only after reimbursement by ticket only."sometimes,To drive the gas bill than medicine high.Cancel after medical treatment,All of the medical insurance for urban workers designated hospital can go to a doctor,Convenient many."

　　中国社会保障研究中心主任褚福灵认为，取消公费医疗，实现更大范围内的医保资金统筹，不仅有利于财政部门集中使用资金，提高效率，而且有利于经济欠发达地区减轻财政负担，对政府、医院、百姓皆有好处，何乐而不为？

China's social security research center director ChuFuLing think,Cancel the medical treatment,To achieve greater range of medical insurance fund as a whole,Is not only beneficial to the financial department to focus on using money,Improve efficiency,And be helpful for undeveloped areas reduce financial burden,For the government/hospital/The people are good,What is there against it?

　　然而，14年过去了，我国31个省区市中，仍有江西、江苏、山东等7省的省会或省直机关等单位，迄今没有实现公费医疗与城镇职工基本医保并轨，部分国家工作人员与普通城镇职工在医疗福利方面仍然差距很大。

however,14 years,The country's 31 in these,Still have jiangxi/jiangsu/Shandong province's provincial capital or 7 ShengZhi authority, and other units,So far, no medical treatment and to realize the urban employee basic medical insurance and the,Part of the state personnel and ordinary town worker in the medical welfare is still a gap.

　　

才改“公费医疗”，又添“补充医保” To change"Medical treatment",added"Supplementary medical insurance"

　　南京市机关事业单位在取消公费医疗、并入城镇职工医疗保险的同时，还要建立“补充医疗保险”，这是该市此次公费医疗改革中的新规定。这种做法虽非先例，但也引起一些群众的质疑。

Nanjing government institutions in cancel to public health care/Merge into town worker medical insurance at the same time,Must build"Supplementary medical insurance",This is one of the city's public health care reform in the new regulations.This kind of practice is the precedent,But also cause some people questioned.

　　究竟什么是“补充医疗保险”？南京市人社局的解释语焉不详。记者反复了解后发现，大概有以下一些内容：一是由财政出资设立公务员医疗补助基金，二是由本级医保中心开设公务员医疗补助支出户，三是对于基本医疗保险最高支付限额以上部分，以及全年自付超过一定数额部分，进行“二次报销”。

What is"Supplementary medical insurance"?Nanjing people club bureau explanation not elaborate.Reporters repeatedly found after understanding,It has the following some content:One is the financial invest to set up a allowance of officeholder medical treatment fund,The second is the health care center by open allowance of officeholder medical treatment household spending,The third is the basic medical insurance for the highest pay limitation above part,And since the pay more than a certain amount of parts,for"Secondary to submit an expense account".

　　北京市2012年取消了公费医疗。该市公务员小林介绍，取消公费医疗后，最大落差是有了“起付线”一说。“以前，哪怕是花一分钱，也可以报销；现在不到‘起付线’，只能自己掏钱。”

The Beijing 2012 cancelled to public health care.The city's civil servants Lin is introduced,Cancel after medical treatment,The biggest head is"Up pay line"said."before,Even if it is to spend a penny,Can submit an expense account;Now less than‘Up pay line’,Can only spend their own money to."

　　但是，有了“补充医疗保险”，即使自己掏钱，也数量有限。以浙江湖州为例，该市一小学老师告诉记者，全年自付部分如果超过3000元，超过部分可以按80%到85%的比例进行“二次报销”。

but,the"Supplementary medical insurance",Even if spend their own money to,Also limited number.Huzhou in zhejiang as an example,The city a primary school teacher told reporters,Since the pay part if more than 3000 yuan,More than part in 80% to 85% of the proportion"Secondary to submit an expense account".

　　据了解，天津、重庆、北京等地，“二次报销”的比例均在75%以上。

It is understood,tianjin/chongqing/Beijing,"Secondary to submit an expense account"The proportion of all higher than 75%.

　　业内人士认为，“补充医疗保险”或者说“二次报销”的做法，将公费医疗改革已缩小或待缩小的差距又拉开了。

The personage inside course of study thinks,"Supplementary medical insurance"or"Secondary to submit an expense account"practice,The public health care reform has shrunk or to narrow the gap and pulled open.

　　一些群众评论说，“公务员补充医疗保险”好怪的名字，为什么又要贴上身份标签，以后会不会有“处级干部再补充医疗保险”以及“厅级干部再再补充医疗保险”？

Some people said the comments,"Civil servants supplementary medical insurance"Very strange name,Why did he labeled as identity tags,Will not have"Place class staff and supplementary medical insurance"and"A cadre again and again and supplementary medical insurance"?

　　专家认为，公费医疗并轨之所以困难重重，一方面是因为有关部门及干部以为这样会损害其医疗福利，另一方面是因为医疗部门面临的管理及改革压力随之加大，特别是一些既得利益者不愿改革。

Experts say,Public health care and are in difficulties,On the one hand, because the relevant departments and cadres think it will damage their medical benefits,On the other hand because the medical department face management and reform pressure then increase,Especially some vested interest is not willing to reform.

　　如今，我国在职工医保、居民医保、新农合等方面的改革明显提速，取消公费医疗已是大势所趋。但是，此项医改也触动了国家工作人员的一部分既得利益，因而阻力重重。“一些干部花国家的钱不心疼，抱着赖一天是一天的消极态度。”

now,China's health care workers/Residents medical insurance/New farming together the reform of speed obviously,Cancel the medical treatment is the trend of The Times.but,The reform also touch the part of the state personnel vested interest,So of all obstacles."Some cadres take national money don't love dearly,Hold on a day is a day of negative attitude."

　　

医疗福利并轨，如何迈向公平？ Medical benefits and the,How to towards fair?

　　北京大学光华管理学院卫生经济与管理学系主任刘国恩指出，医保改革亟待扩大资金统筹的覆盖面。可以说，将国家工作人员与城镇职工基本医疗保险并轨是这项改革的第一步。“将‘碗里的’合并到‘锅里’，才能提高医保资金的使用效率”。

Peking University guanghua school of management health economic and management department LiuGuoEn pointed out,Health-care reform to expand the coverage of the capital as a whole.Can say,National staff and urban employee basic medical insurance and is the first step of the reform."will‘bowl’Merge to‘pot’,To improve health care efficiency in the use of funds".

　　据分析，公费医疗改革过程中，国家工作人员并轨进入城镇职工基本医保，是医疗保险制度改革的核心内容。而一些地方“基本医保＋医疗补助”的做法，有可能导致不同身份人员的医疗福利产生新的不公。

According to the analysis,In the course of the reform of medical treatment,State functionaries and into the town worker is basic medical insurance,Medical insurance system reform is the core content of.And some places"The basic medical insurance and medical aid"practice,Can lead to different identity personnel's medical benefits generate new injustice.

　　褚福灵认为，取消公费医疗，本来可以消除不同身份人员在制度上的不公平。而“补充医疗保险”的出现，导致“一波未平，一波又起”，是公费医疗特权的借尸还魂。

ChuFuLing think,Cancel the medical treatment,Could eliminate the different status in the system of personnel is not fair.and"Supplementary medical insurance"appear,Lead to"A wave of open,after",Medical treatment is the privilege of rebirthing.

　　一些专家指出，“补充医疗保险”既可以是商业保险，也可以是社会保险，并不是国家工作人员的专利。这项保险还包括职工互助保险、商业医疗保险等多个种类，有关单位和个人可以自行选择。

Some experts say,"Supplementary medical insurance"Can be commercial insurance,Also can be the social insurance,And is not the patent of national staff.The insurance includes worker mutual insurance/Commercial medical insurance and so on many kinds,The relevant units and individuals can choose.

　　褚福灵认为，取消公费医疗不是要一味地拉低国家工作人员的医疗待遇，而是要实现更大范围的福利公平。近年来，城镇职工医疗基本保险的水平不断提升，报销比例在制度规定范围内大概是80%-90%，与公费医疗接近。

ChuFuLing think,Cancel to public health care not to blindly down state personnel of medical treatment,But to achieve a greater range of welfare fair.In recent years,The basic medical insurance for urban workers to improve the level of,Reimbursement ratio in the system the specified scope is about 80% - 90%,And close to medical treatment.

　　“如果城镇职工医疗基本保险今后能取消‘起付线’和‘封顶线’，一些国家工作人员的‘补充医疗保险’也就没有必要存在了。”褚福灵如是说。

"If the town worker medical treatment to basic insurance will be cancelled‘Up pay line’and‘Top line’,Some countries staff‘Supplementary medical insurance’There would be no need to exist."ChuFuLing said.

　　十八大报告要求，逐步建立以权利公平、机会公平、规则公平为主要内容的社会保障体系。“现行的公费医疗改革，距离这一要求还有不小的差距。”网民“听风看海”这样留言道。(记者叶超、周婷玉、潘晔、张淼淼)

The eighteenth big reporting requirements,Gradually establish a fair right/Fair chance/Rules fair as the main contents of the social security system."The current public health care reform,Distance the requirement and large gap."netizens"Listen to the wind, the sea"This message word.(Reporter YeChao/ZhouTingYu/PanYe/ZhangMiaoMiao)