据中国之声《新闻纵横》报道，病没医好，重病患者却被要求立即出院。原本被告知只是假出院，可马上重办入院手续，却又被医院临时通知出院一周后，才能再次入院治疗。

According to the sound of China[News aspect]reports,Disease didn't healed,Critically-ill patients was asked the hospital immediately.Originally was told only false discharge,Can immediately replace whatever be admitted to hospital formalities,While the hospital short notice a week after discharge,Can once again to the hospital for treatment.

　危重病人被强制"假出院"离世 Critically ill patients were forced"False discharge"From the

　　这样的怪事发生在广州读博士的龚晓峰身上，去年10月，他51岁的母亲长途跋涉从四川来到广州治病，却因为广州某医院强制其出院，结果导致病情恶化、撒手他乡。昨晚，他接受了中国之声的采访，痛诉了这段经历：

Such a strange thing happened in guangzhou Dr Read GongXiaoFeng body,Last October,,He 51 years old, the mother of a long journey from sichuan to guangzhou cure,But because guangzhou a hospital to enforce its discharge,The results lead to take a turn for the worse/Fold up land.Last night,He accepted the interview the sound of China,Pain v. the experience:

　　龚晓峰：当时是这样的，在我母亲住院第19天的时候，我就询问医生我母亲的病情。医生当时问我我母亲住院多久了，我回答是19天，他说按我们医院的一般规定，住院17天要办理一个转院手续，就是出院再入院，也叫假出院手续。于是第二天我父亲马上就把这个手续办了，但是办理以后，半个多小时以后医生通知我父亲，他说假出院变为真出院。当时很突然，我们当时提出来，如果是由于医保的限制我们不能住院，我们愿意自费住院。后来科室主任还是不同意，出院60多个小时之后她突发告烧后来送到医院去抢救，我母亲病情就急转直下，这样就导致了悲剧。

GongXiaoFeng:At that time is such,My mother was in hospital in 19 days,I will ask the doctor for my mother's illness.The doctor was asked me how long have I mother was in hospital,My answer is 19 days,He said the general provisions in our hospital,17 days in hospital should deal with formalities of a hospital,Is the hospital readmission,Also called false leave hospital formalities.Hence the second day my father soon this procedure done,But after the deal with,More than half an hour later the doctor inform my father,He said false discharge into true discharge.Was suddenly,We were out,If it is due to the limitation of the hospital medical insurance we can't,We are willing to hospital at one's own expenses.Later the department director or don't agree,The hospital more than sixty hours later she burst against burn later to the hospital to rescue,My mother's illness was plunged,This caused the tragedy.

　　龚晓峰说，母亲去世后，他觉得对这一切都不理解。医院为什么要让他们假出院？为什么不继续治疗病重的母亲？直到后来有人告诉他，这是"医保总额预付制"惹的祸。

GongXiaoFeng said,After her mother died,He thought of all this don't understand.The hospital why want to let them false discharge?Why not continue to treat seriously ill mother?Until he was told,This is"The total advance medical insurance system"To blame.

　　所谓"医保总额预付制"，是医保付费常用模式的一种，就是医保经办机构每年向定点医疗机构划拨一定的总额，在这个基础上，医院有结余则留用，超支则与医保机构分担。这就像是去饭店点菜，饭店当然希望多点菜多赚钱。现在是直接跟饭店谈，比如一桌菜1000块钱，饭店来配菜，饭店自然就会想节约成本。

The so-called"The total advance medical insurance system",Medical insurance is a kind of commonly used for model,Medical insurance agency orgnaization is every year to nod medical establishment transfer a certain amount,On this basis,The hospital has balance is retained,Overspend, and health care institutions to share.It's like going to the restaurant to order,Hotel certainly hope more order to make more money.It is directly with the hotel about,Such as a $1000 desks,Restaurant dishes,The hotel will naturally want to save cost.

　　设计这项制度的初衷是为了遏制医院过度医疗，随意开大处方、乱检查、乱收费。然而，实际操作中却出现了意想不到的后果：一些地方的医院通过分解患者诊疗次数、分解住院甚至假出院方式，逃避医保控费下对医院各种指标的考核，给患者平添数不清的麻烦，甚至危及患者生命。

Design the system of the original intention in order to curb the hospital excessive medical treatment,Optional open DaChuFang/Random inspection/Collects fees in disorder.however,The actual operation there appeared in unintended consequences:Some parts of the hospital through the decomposition with the number of diagnosis and treatment/Decomposition in hospital or even false discharge mode,Escape to the hospital medical insurance cost control all kinds of index evaluation,To make the same score with countless trouble,And even endanger the patient life.

　部分医院怕超额推诿病人 Part of the hospital afraid of excess shuffle patients

　　像龚晓峰的母亲一样，遭遇医院推诿的病人并不是个例。比如有媒体去年底报道说，上海的一位患者在就医时被告知，医保额度已用完，只能开一周的中药，且不能超过80元，除非转为自费病人；同样由于医保控费压力，山东济南社保局统计显示，2011年共有270名医保病人被医院拒收。

Like GongXiaoFeng mother,Hospital patients with responsibilities are not case-by-case.Such as media reported late last year,One of the patients in Shanghai when go to a doctor was told,Medical insurance limit has run out,Can open a week of traditional Chinese medicine,And not more than 80 yuan,Unless to patients at one's own expenses;Also because of health control cost pressure,Shandong jinan social security bureau statistics show,In 2011, a total of 270 health care hospital patients were rejected.

　　自1997年起，总额预付即在江苏镇江试点推行，此后，逐步扩大到上海、北京等新医改试点城市及县医院改革试点地区。今年1月1号开始，河南省18个省辖市也开始全部实行医保总额预付制。

Since 1997,Is the total advance in jiangsu zhenjiang pilot implementation,Since then,Gradually enlarged to Shanghai/Beijing new medical reform pilot cities and county hospital reform pilot area.Begin on January 1 this year,Henan province and cities began to implement a full medical insurance amount prepaid system.

　　"医保总额预付制"凸显制度缺陷 "The total advance medical insurance system"Highlight system defects

　　这两天，在河南省正在召开的"两会"上，有人大代表就"医保总额预付制"遇到的问题提出了相关议案。

These two days,In henan province are held"lianghui"on,A National People's Congress is"The total advance medical insurance system"The problems put forward the relative motion.

　　2012年二季度起，河南全面实施新农合基金总额预付结算方式。今年1月1日， 全省18个省辖市将全部实行医保付费制度改革，实行以总额预付为主、多种付费方式相结合的复合付费方式。但在杨奎看来，压力转移到了基层医院，患者的就诊环境也有所改变，甚至被医院"踢皮球"：

In 2012, the second quarter,Henan full implementation of new farming together a total fund advance the method of payment.January 1,, The eighteen cities will pay all the medical insurance system reform,The total advance to give priority to/The combination of various methods of payment composite payment.But in YangKui looks,Pressure was transferred to the basic-level hospitals,Patients with medical environment has also changed,Even by the hospital"Kick a ball":

　　杨奎：医保超额的问题它是解决了，费用增长的矛盾转嫁到医疗机构上去了。做了大手术越多越赔钱，做了越难的病人越重的病人越赔钱，大家就捡那些比较轻的好治的，花钱少的来治，医生不能因病施治，他是看钱看病。新的技术没法应用，一用就超。

YangKui:Medical insurance excess problem it is solved,Increased costs are passed on to the contradiction between medical institutions up.Do the surgery the more the loss,The more difficult it is for the patients of the heavier the patient loses money,We will pick up those lighter well treated,Frugal to cure,The doctor can't by illness,He is to see money to see a doctor.The new technology can't application,Use a super.

　　其实，早在2007年，河南已安排新乡市率先试行付费方式改革，随后洛阳、焦作、许昌等市也相继开展。河南省卫生厅曾下发通知，一旦发现医疗机构有推诿患者、降低服务质量、转嫁费用负担等不规范行为，将暂停相关医师医保服务；情节严重的还将暂停相关病区或医疗机构医保服务。杨奎代表调研发现，这也让在一线工作的医生们压力很大：

In fact,As early as in 2007,Henan xinxiang has arranged for the payment reform,Then luoyang/jiaozuo/Xuchang city in one after another.Henan provincial health bureau has issued a notice,Once found that medical institutions have shuffle patients/Reduce the quality of service/Shifting cost burden of irregularities,Doctors will be suspended related medical insurance service;If the circumstances are serious will suspend relevant medical institutions) or medical insurance service.YangKui representative survey found,This also let in a line of doctors under a lot of pressure:

　　杨奎：这样谁都不敢干了，干活赔钱，不干不会罚钱了。

YangKui:Who then can't dry,Work loss,Do not fined.

　　杨奎坦言，医疗费用的增长，涉及药品、医疗器械招标及医院内部管理等多方面原因，一些医院过度医疗、开大处方、乱收费确实存在，但先进医疗技术手段的使用也是其中的合理一环，不能简单的用一个矛盾压制另一个矛盾。他建议：

YangKui said,The rising cost of medical treatment,Involving drugs/Medical equipment bidding and hospital internal management and so on the various reason,Some hospitals excessive medical treatment/Open DaChuFang/To collect fees in disorder exists,But the use of advanced medical technology is one of the reasonable a ring,Can't simply use a contradiction pressing another contradiction.He suggested that:

　　杨奎：按病症付费，比如这个病人做这一类的手术应该给你多少钱，细化一点。医疗费用上涨是综合因素，要多方面解决问题。医疗必须按照医疗规程来做，按照临床路径来走，不能过度检查，也不能过度治疗，你只能在这上面加强监督检查，你如果在这里面发现过度治疗了拒付费，这样一分钱不付都没问题。

YangKui:Pay according to the disease,Such as the patient to do this kind of operation should give you much money,Refining a little.Medical costs rise is a comprehensive factors,To solve various problems.Medical must, in accordance with medical procedures to do,According to the clinical path to walk,Cannot excessive examination,Also cannot excessive treatment,You can only on it to strengthen supervision and inspection,If you in here found excessive treated protest fee,So don't pay a cent is no problem.

　　原本意在管控过度医疗的新型付费方式，带来的却是推诿病人、降低服务标准的副作用，这既不是制度设计者的初衷，也不是广大患者所乐见。打向过度医疗的重拳，无形中给医院和医生施加了压力，也间接伤及了部分无辜的患者。怎样在控制医保总额的同时，保证医院对病人的诊疗质量和效果，改革的设计者需要正视这些问题，也需要在实践中不断修正和完善。

Originally intended to control excessive medical new payment,Bring is shuffle patients/Lowering the standard of service side effects,This is neither system designer's original intention,Is not the majority of patients were happy.Play to excessive medical punch,Virtually to the hospital and the doctor put pressure,Also indirect injury and some innocent patients.How to control the medical insurance amount at the same time,Ensure the hospital to the patient's diagnosis and treatment quality and effect,Reform of the designer needs to face up to the problem,Also in practice need to revise and perfect.