5日中午，记者在代表团驻地见到了全国人大代表、卫生部部长陈竺。结合政府工作报告，针对社会关注的医改问题，他坦然回答了记者一系列的提问。

5, at noon,Reporter see in missions of the National People's Congress/Minister of health Chen zhu.Combined with the government work report,In view of the society pay close attention to health problems,He answered the reporters in a series of questions.

　　大病医保也想全覆盖，但必须考虑“卫生经济学” Complete coverage of serious illness insurance also want to,But must be considered"Health economics"

　　记者：政府工作报告提出，今年将全面开展儿童白血病等20种重大疾病保障试点工作。选这20种病是出于什么考虑？

reporter:The government work report,This year will be fully carried out 20 kinds of major diseases such as leukemia children protection pilot work.Choose the 20 kinds of disease is for the sake of what?

　　陈竺：我很荣幸，总理今天的政府工作报告又把那20个大病列出来了。那就是卫生部建议的，而且我本人直接领着专家，一个病一个病地细细研究。我也想全覆盖，但问题是，必须要考虑到成本效益问题，就是我们说的“卫生经济学”。我们不可能把钱用到那些实际上治不太好的病上，比如有的癌症到了中末期，即使做移植，对健康的效益还是很低的。所以我们挑选的病种都是儿童病、妇女病，加上一些特困的群体会因病治贫、因病返贫的病种，这些又是费用可控、疗效确切的病种。之所以先从这20个大病切入，就是这样一种想法。

Chen zhu:It is my honor to,Prime minister's government work report today and make a list that 20 serious illness.It is recommended by the ministry of health,And I am directly led the experts,To study a disease, a disease.I also want to cover all,But the problem is,Must take into account the cost and benefit issues,Is what we said"Health economics".We can't use the money that is actually not very good cure disease,Such as some cancer during,Even with a transplant,The health benefits still very low.So we choose disease is disease of children/Gynecological diseases,Plus some special difficult groups will ZhiPin because of illness/Chinese diseases because of illness,These costs under control/Curative effect of the disease.Is from the first 20 serious cuts,Is one such idea.

　　卫生机构改革：希望实现“三医联动” Health organizational reform:Want to achieve"3 d linkage"

　　记者：新一轮机构改革，卫生领域有什么变化？

reporter:A new round of institutional reform,Any change in health?

　　陈竺：管理构架改革，这一次可能涉及到卫生部门的机构改革、职能转变，应该说涉及面比较大、也比较深。我们很希望下一步实现医保、医药、医疗“三医联动”。希望职能转变向一个统筹的方向去发展，不要把这些管理职能割裂开来。

Chen zhu:Reform of management structure,This time may involve the health sector reform/Functional transformation,It should be said is bigger/Also more deep.We hope that the next step to realize health care/medicine/medical"3 d linkage".Hope functional transformation to develop in the direction of a plan as a whole,Don't put these management functions.

　　记者：现在农民工流动性很大，医保全国异地报销的问题还没有解决，您认为该从何入手？

reporter:Peasant workers' liquidity is very big now,Coverage beyond the reimbursement of the nation's problems haven't solved,What do you think of where to start?

　　陈竺：现在省内异地报销已经实现，全国正在做试点，涉及信息平台的问题。现在群众期望值越来越高，要求最好是先诊疗后付费，最好是即时结报。这需要国家层面要有个统一的信息系统，做到省与省之间能通。估计卫生部门职能调整以后，未来要逐步走向医保管理的合一，肯定是这个趋势。

Chen zhu:Now long-distance reimbursement has been achieved in the province,The pilot is doing,Problems involving information platform.Now the expectation is higher and higher,After paying for it is better to diagnosis and treatment,It is best to instant knot.This requires national level need to have an unified information system,Do it between the province and can pass.Estimate the health sector functions after adjustment,To gradually toward the future of health care management,Must be the trend.

　　抗癌药即将纳入基本药物目录，缓解“看病难”需构建“医联体” Cancer drugs coming into the list of essential medicines,ease"The doctor is difficult"Need to build"D of couplet"

　　记者：医改这么多年，挂号难、住院难依然存在，应该怎么解决？

reporter:Health care for so many years,Registered to/Hard to remain in hospital,How to solve?

　　陈竺：最重要的是让基层医院真正强起来，和大医院形成上下联动、沟通，最好是一体化的构架，我们把它称之为“医联体”。现在大医院还是人满为患。去年全国诊疗人数已接近69亿人次，前年是62亿人次，平均每个中国人每年看病5次以上。基层的诊疗量在上升，但大医院上升得更快。如果这种情况不能得到扭转，我们要提高国民健康水平，特别是要应对慢性病这个健康的主要威胁，是不可能的。一个医生一天要看几十个患者，他怎么能做到慢性病的长期管理？只有在社区可以实现“家庭责任医生制”，签约服务。

Chen zhu:One of the most important is to make the basic-level hospitals really strong,Formation of upper and lower linkage and big hospital/communication,It is best to integration architecture,We call it"D of couplet".Now big hospital is overcrowded.Last year the national medical number is close to 6.9 billion people,Is 6.2 billion the year before last,The average Chinese doctor more than 5 times a year.Grassroots ZhenLiaoLiang is on the rise,But the big hospital rise faster.If the situation cannot be reversed,We need to improve national health level,Especially to deal with this chronic disease the main threat to the health,It is not possible.A doctor to see dozens of patients a day,How can he achieve the long-term management of chronic diseases?Only in the community can be achieved"Family doctor system",Contract signing.

　　这几年社区医院能力有所加强，但人才队伍还是欠缺。医学专业大学生都愿意去大医院做专科，就不愿意去基层医院做全科。殊不知，全科在全世界范围内被认为是最重要的一个专科。最近我提出，大医院要建立“全科医学科”，动员大医院的一些医生通过全科医学这样一个平台下沉下去。

Community hospital ability strengthened over the years,But talent is still lacking.Medical professional college students are willing to go to large hospital specialized subject,Just don't want to go to grassroots hospital for general practice.Little imagine,Around the world in general is regarded as one of the most important specialized subject.I recently put forward,To build big hospital"General medicine",Mobilization of some big hospital doctors through such a platform sinking in general medicine.

　　这里涉及两个问题，一是人事制度，你怎么评价。如果大家都认为只有专科医生是一流的，三流医生才去做全科，那就无法调动积极性。二是医保非常重要。不同层级的机构有不同的财政制度渠道。如果能把医保力量发挥出来，就能克服很多行政障碍。如果医保能按基层、二级、三级医院这样一个总包体系去报销，自然会促进医疗资源的下沉，因为对服务体系来说，它下沉以后，成本一定是下降的，效率肯定是更高的。只有在基层才管得住经常性的慢病、健康促进。

Here involves two problems,A is the personnel system,How do you evaluate.If everyone thought that only a specialist is top-notch,Third-rate doctors to do the general practice,It won't be able to mobilize enthusiasm.2 it is medical care is very important.Institutions at different levels have different financial system channels.If you can make health power,Many administrative hurdles can be overcome.If the health insurance will be effected according to the basic level/The secondary/Tertiary hospital in such a system of the contractor to submit an expense account,Will promote the medical resources in the sink,As for service system,It sank after,Cost must be falling,Efficiency is higher.Only at the grassroots level tube to regular slow disease/Health promotion.

　　记者：老百姓反映，现在看病贵主要还是买药贵。这个问题应该怎么解决？

reporter:People to reflect,Now the doctor is expensive is main or buy medicine.This problem should be how to solve?

　　陈竺：第二版基本药物目录马上要出来了，药品从第一版307种扩大为500多种。第一版只是基层版，像抗癌药、心血管重症药、神经系统和精神类用药、血浆制品等一个都没有，这次基本都有了。

Chen zhu:The second version of the list of essential medicines will soon come out,More than 307 kinds of drugs from 307 kinds of expanded for the first edition.The first edition is only basic version,Like a cancer drug/Critical cardiovascular medicine/Neurological and psychiatric drugs/Plasma products such as a all have no,Basic all have this time.

　　医患关系：医生收入不能靠赚最弱势群体的钱 The doctor-patient relationship:The doctor income can't make money out of the most vulnerable groups

　　记者：去年全国发生了多起医生被砍事件，对目前医患关系紧张的问题您怎么看？

reporter:Several doctors cut event happened last year,At present the doctor-patient relationship nervous problem what do you think?

　　陈竺：如果说群众为了看一个大病花费很高，但由于医学的不确定性又治不好，最后人财两空，心里肯定会不平衡。一定要改革掉以药补医的弊端。如果一个医院生存、医生收入是依靠从最弱势的群体身上赚钱，医患关系能好吗？(记者李柯勇、许祖华、周婷玉)

Chen zhu:If the crowd to see a major cost is very high,But because of the uncertainty of the medical cure,The last goods,The in the mind will not balance.Must reform off with medicine and medical malpractice.If a hospital survival/The doctor income depend on money from the most vulnerable groups,The doctor-patient relationship can good?(The reporter Li Keyong/Xu Zuhua/Zhou Tingyu)