医改：何时才算成功 Health care reform:When in order to be successful

医改至繁至难，公众预期却是又好又快，究竟本轮医改将怎样弥合二者差距，抵达成功的“彼岸”。 Health reform to complex to difficult,The public is expected, nice and fast,How this reform will bridge the gap,Arrived in success"The other shore".

　　在持续3年的努力后，新医改将要抵达的“彼岸”似乎渐具轮廓。

After the last 3 years of efforts,New health reform is going to arrive"The other shore"Seems to be getting contour.

　　根据本轮医改的目标，其勾勒出的“彼岸”大致为：建立健全覆盖城乡居民的基本医疗卫生制度，为群众提供安全、有效、方便、价廉的医疗卫生服务。

According to the current health care reform goals,The outline of the"The other shore"roughly:Establish and improve the basic medical and health system covering both urban and rural residents,Provide security for the masses/effective/convenient/Medical and health services at low price.

　　围绕这一目标，3年来，新医改攻城拔寨的力度从未削减，并在基层的医改战场上率先实现突破：

Around this goal,For three years,The strength of the new reform is gaining village has never been cut,Health care reform take the lead to achieve the breakthrough on the battlefield and at the local level:

　　在资金筹集上，筑牢“保障网”，看病更省钱。经过三年医改，我国已经建立起以新农合、城镇居民医保、职工医保为主体，以多种补充保险和商业保险为辅助，以大病救助为兜底的中国特色的全民医保体系框架，织起了一个世界上覆盖人口最多的医疗保障网，使13亿多人口“病有所医”有了基本的制度保障。目前，城乡居民参加三项基本医保人数超过13亿，覆盖率达到95%以上；城镇居民医保、新农合政府补助标准提高到了240元，政策范围内住院费用报销比例提高到70%左右，人民群众看病负担有效减轻。

In a fund-raising,Build a"Safety nets",The doctor is more save money.After three years of health reform,Our country has established a new farmers/Urban residents medical insurance/Worker health care as the main body,In a variety of supplementary insurance and commercial insurance for auxiliary,With a serious illness for out of universal health care system framework with Chinese characteristics,Knit up a health care coverage in the world's most populous Internet,Make more than 1.3 billion people"In sickness"Have a basic institutional guarantee.At present,Urban and rural residents to participate in the three basic medical insurance more than 1.3 billion people,Coverage of 95% or more;Urban residents medical insurance/New farmers and government subsidy standards increased to 240 yuan,Policy within the scope of hospitalization expense proportion increased to 70%,The people see a doctor effectively reduce the burden.

　　在服务供给上，增强“可及性”，就医更方便。由于我国70%的医疗服务需求发生在基层，而基层恰恰是整个医疗服务体系中最为薄弱的环节，于是，新一轮医改选择从基本入手、从最薄弱的环节改起，把大量的资金、财力投向基层，把更多的人才、技术引向基层，重点保障中低收入群众，让农民和困难群体优先享受到医改带来的实惠。三年来，在农村，中央投资支持了2233所县级医院(含县级中医院)、6200多所中心乡镇卫生院、2.5万多所村卫生室的建设；在城市，中央投入则惠及2382所社区卫生服务中心建设。

On the service supply,To enhance"accessibility",It is more convenient to go to a doctor.Because our country 70% occurred in grassroots medical service demand,And base is the most weak link in medical service system,so,A new round of reform, from the perspective of the basic choice/Since change the weakest link,Put a lot of money/Financial resources to basic,The more talent/Technology to the grassroots,Focus on security in the low-income people,For farmers and disadvantaged groups preferred to enjoy affordable health care.In three years,In the countryside,The central investment support 2233 county-level hospitals(Of the hospital)/More than 6200 centers in towns and townships/The construction of more than 25000 village clinics;In the city,The central investment will reach 2382 community health service center construction.

　　这显然是一份令人鼓舞的答卷，但还不是一份能够说服全体公众的完美答卷。在一部分人看来，“看病难、看病贵”的状况尚未得到有效缓解。

This obviously an inspiring answers,But it's not a perfect answer to persuade the public.In the part of the people,"The doctor is difficult/See a doctor expensive"Condition has not been effective.

　　对此，卫生部部长陈竺曾解释说，3年医改，重点在基层，成效也在基层，特别是农村。对公立医院特别是公立大医院而言，改革还没有真正改到它们，所以城市居民自然不会有明显的感受。

For this,Minister of health Chen zhu has been explained,3 years health care,Focus at the grassroots level,Results at the grassroots level,Especially in the countryside.For public hospitals, especially public hospitals,Reform has not change real to them,So the city dwellers obviously does not have a feeling.

　　而在不同人群获益程度不同的因素之外，医改本身的渐进性特点，也决定了医改目标的实现绝非朝夕之功。如果承认中国医改的复杂，那么应当看到，这3年的医改总体仍处在“跑量”的阶段，主要诉求是补短板，尚有待“量变引起质变”。

And the different levels of people benefit from different factors,The progressive characteristics of health care itself,Also decided to achieve the goals of health reform is by no means one day work.If admitted that China reform of complex,You should see,This health overall is still in 3 years"mileage"The stage of,Main demand was for a short board,Remains to be"Quantitative change causes the qualitative change".

　　此外还需了解，对整个卫生系统而言，虽然筹资体系和服务体系是最为核心的组成部分，并且二者在过去3年的医改中均有不俗表现，但筹资体系的改革步伐明显领先于服务体系，社会诟病的“以药养医”机制还未根除，这显然是新医改成功抵达“彼岸”的心腹大患。

In addition also need to know,For the entire health system,Although financing system and service system is the most part of the core,And both in the past three years is not common in health care,But the pace of reform of financing system significantly ahead of the service system,Social criticism"Medicine for the medical"Mechanism has not been eradicated,It's clearly a new reform success"The other shore"The menace of.

　　尤为紧迫的是，医疗服务体系改革至繁至难，公众却往往怀着又好又快的心理预期，其间差距，弥合不易。

Is particularly urgent,Medical services system reform to complex to difficult,The public are often left with a psychological expectations, nice and fast,In the gap,Bridge is not easy to.

　　从微观层面看，由于长期以来财政投入不足，合理补偿机制欠缺，公立医院不得不靠“以药补医”维持运营，最终酿成社会不断抨击的“大处方”、“大检查”、“红包”、“回扣”等医界乱象。新医改的手术刀，势必触及既得利益者的奶酪，阻力可想而知。

Look from the micro level,Due to the insufficient financial input for a long time,Lack of reasonable compensation mechanism,Public hospitals have to rely on"With medicine cure"Maintain operations,Ultimately society continues to attack"excessive"/"Big check"/"A red envelope"/"rebates"Such as profession is mess.New reform of a scalpel,Cheese is bound to hit a vested interests,The resistance is.

　　从宏观层面看，当前中国正处于工业化、城市化快速发展时期，人口老龄化进程加快，面临的健康问题日趋复杂。一方面，重大传染病流行形势依然严峻，慢性非传染性疾病和精神疾病对人民群众的健康威胁日益加大，新发传染病以及传统烈性传染病的潜在威胁不容忽视。另一方面，生态环境、生产生活方式变化以及食品药品安全、职业伤害、饮用水安全和环境问题等对人民群众健康的影响更加突出。不断发生的自然灾害、事故灾害及社会安全事件也对医疗卫生保障提出更高的要求。医疗卫生服务供给与需求之间的矛盾日趋突出，服务理念、服务模式等亟需作出相应调整。

From the macroscopic level,The current China is in industrialized/Period of rapid urbanization,Population aging process was accelerated,Health problem has become increasingly complex.On the one hand,The major infectious diseases epidemic situation is still grim,Chronic noncommunicable diseases and mental health of the people's growing health threats,Emerging infectious diseases and traditional should not overlook the potential threat of deadly infectious diseases.On the other hand,The ecological environment/Changes in lifestyle and food and drug safety in production/Occupational injuries/Drinking water safety and environmental issues affect people's health become more prominent.Natural disasters that happen continuously/Accidents disasters and social safety incidents of medical and health security also put forward higher request.Medical and health services the contradiction between supply and demand become increasingly prominent,Service concept/Service mode, etc. Needs to be adjust accordingly.

　　所幸，虽然新医改仍然面临诸多困难和挑战，但与起步阶段相比，目前改革方向更加明确、组织保障更加健全、改革的社会环境也更为有利。因此，站在这个节点，2020年“人人享有基本医疗卫生服务”的既定目标也更为清晰。(记者 张冉燃)

Fortunately,,While the new healthcare reform still faces many difficulties and challenges,But compared with the early stage,Current reform direction more clearly/The organization security will be further improved/Reform of the social environment is more beneficial.so,Standing on the node,In 2020,"Everyone will have access to basic medical and health services"The goal is more clear.(Reporter zhang ran combustion)