为啥利好政策一天两变？政策全面推行难在哪里？ Why good policy a day two variable?The full implementation of the policy to where?

　　晚报记者采访后得知：不管卫生部的“先看病后付费”制度啥时候覆盖全国，有了云南省中医院推出的“患者说了算”服务模式，患者都能够在这间医院抢先体验“交不交住院押金、检查方法、治疗方式、治疗药物、选择医护、收费是否合理、满不满意、保健康复”等8项内容自己说了算的医疗服务。

Evening news reporters learned that after:Regardless of the ministry of health"After the first doctor pay"What time system covering the whole country,The launch of the yunnan province hospital of traditional Chinese medicine"Patients have the final say"Service mode,Patients in this hospital can experience first"Don't pay the deposit in hospital/Inspection method/treatment/drugs/Choose medical/Charge is reasonable/Full not satisfied/Health rehabilitation"Eight and decide the content of the medical service.

　一天两变 One day two variable

　　“先看病后付费”引关注 "After the first doctor pay"attention

　　昨日上午，央视新闻报道，今年，卫生部将全面推行“先看病后付费”制度。央视新闻中心的官方微博“央视新闻”也将这一制度的情况以通俗易懂的方式进行了发布，“原来看病是自己先垫付，看完走医保报销；现在是医院垫付，病人看完病只用交自己的那部分，其余由医保部门支付给医院。此外，原来住院需要交一大笔押金，现在只用签署《住院治疗费用结算协议书》就可以直接住院了。”据悉，该制度已在山东的部分医院进行了试点。

Yesterday morning,CCTV news reports,This year,The full implementation of the sanitation department"After the first doctor pay"system.CCTV news center official micro bo"CCTV news"Will this system in easy to understand the way release,"Originally the doctor is his first disbursements,Finish see go medical insurance reimbursement;Now is the hospital disbursements,Patients with watching the disease into the part,The rest pay by health care providers to the hospital.In addition,The original hospital to need to pay a large sum of deposit,Now only signed[Hospitalization cost settlement agreement]You can directly in the hospital."It is reported,This system has set up a file in the shandong part of the hospital for the pilot.

　　利好消息一出，立即引发关注。可是大家还没来得及高兴，又一条新闻出炉“卫生部否认要求全面推行‘先看病后付费’模式”。

A good news,Immediate cause attention.But we haven't enough time to happy,And a hot news"The ministry of health denied the full implementation of the requirements‘After the first doctor pay’mode".

　　卫生部医政司医疗管理处处长焦雅辉回应媒体报道“今年全面推行‘先看病后付费’制度，部分医院试点”的新闻时称，关于“先看病后付费”模式，卫生部倡导在有条件的地区开展试点，但从未要求“全面推行”。

The ministry of health YiZhengSi medical management everywhere telephoto, bright response media reports"This year, the full implementation of the‘After the first doctor pay’system,Part pilot hospital"News as,about"After the first doctor pay"mode,The ministry of health advocates in conditional area to pilot,But never ask"The full implementation of the".

　　目前，全国20多个省份正对此进行探索。但受社会征信体系、医保报销水平等条件限制，这种模式短期内无法全面推行。

At present,The national more than twenty provinces are to explore.But the social credit system/Medical insurance reimbursement level conditions,This model in the short term can't the full implementation.

　记者调查 Journalists to investigate

　　政策全面推行难在哪 The full implementation of the policy to

　　业内人士表示，如果要在县级以上的大医院推行“先看病后付费”制度模式，没那么容易。一方面是因为医保报销比例低。比如，患者在乡镇医院可报销90%，在县级医院可报销75%，市级医院可报销50%，在省级医院或跨省医疗报销比例更低。此外，一部分无医保、无新农合就医者，如外来打工者等低收入自费群体等，无能力归还高额医疗费用。也就是说，由于大城市医院的欠款风险高，医院的切身利益无法保障，这种医疗服务模式推行存在一定的困难。另外，“先看病后付费”在大医院推行存在一定的难度，比如，医保和全国的财政机构并没有全国联网，医保结算存在很大难度；且由于户籍制度限制，病人身份很难确定。“诚信体系、是否会出现恶意欠款等问题也是影响这一制度能否顺利推行的关键。”(王劲松)

The personage inside course of study says,If you want to in the implementation of the hospital at or above the county level"After the first doctor pay"System model,Not so easy to.On the one hand because of medical insurance reimbursement ratio is low.Such as,Patients in hospital can submit an expense account 90% of villages and towns,In the hospital at or above the county level may submit an expense account 75%,The municipal hospital can submit an expense account 50%,In the provincial hospital or across the province medical reimbursement ratio even lower.In addition,Part no medical insurance/No new farmers who together go to a doctor,Such as migrant workers, such as low income at one's own expense group, etc,No ability return high medical costs.that,Due to the big city hospital credit risk high,Unable to safeguard the interests of the hospital,The medical service mode it is difficult to implement.In addition,"After the first doctor pay"In the big hospital implementation has certain difficulty,Such as,Medical insurance and the national financial institutions and no nationwide network,There is a big difficulty medical insurance settlement;And because of the household registration system limit,The patient identity is difficult to determine."Credit system/Whether there will be malicious arrearage problems is to influence the system can be the key to the smooth implementation."(Wang jinsong)