昨日，北京，全国政协委员、卫生部副部长黄洁夫被媒体围访。当天下午，他参加了医卫界分组讨论。图/CFP yesterday,Beijing,The CPPCC national committee/Deputy health minister huang jiefu was media to visit.In the afternoon,He took part in the YiWeiJie group discussions.Photo/CFP

●绝大多数医生每天都在救死扶伤，无意被奉为“白衣天使”，也不容忍被丑化为“白狼”。 "The vast majority of the doctor to heal the wounded and rescue the dying every day,Not be as"White angel",Don't stand for been demonised"The white Wolf".

　　——全国政协委员、卫生部副部长黄洁夫认为，医患矛盾主要是因为民众的医疗服务要求与我国优质医疗资源不足及医疗卫生体制改革滞后造成的。医生和病人都是医疗冲突的受害者。 - the CPPCC national committee/Deputy health minister huang jiefu said,The doctor-patient contradiction is mainly due to people's health service requirements with high quality medical resources shortage in our country and medical and health system reform lags behind.Doctors and patients are the victims of medical conflicts.

　　●为满足患者就医需求，很多大医院开放号源，导致很多医生超负荷工作。与辛勤付出不相匹配的是医生的收入和社会地位的相对下滑，这就是一些医生对医改持消极观望情绪的原因。 Low to meet the demand of patients go to a doctor,A lot of big hospital open source,Lead to many doctors overload.With hard work does not match the relative decline of the doctor's income and social status,This is some doctors to reform a negative wait-and-see mood.

　　——黄洁夫认为，今后医改方案设计应让医生有较高社会地位和体面收入。 - Huang Jiefu thought,For health care reform plan design should allow doctors to have higher social status and decent income.

　　“医院没有不搞‘科室核算’的，您给我们发过工资吗？您说医院先救人后收钱，这笔花费是您给还是民政局付？”一个早在2007年就诞生的“小医生含泪10问卫生部长”的帖子再次引发关注。

"No no hospital‘Department of accounting’the,Have you sent us a wage?You said the hospital to save money,The cost is you pay or the civil affairs bureau?"A born as early as 2007"Asked the little doctor tearful 10 health minister"Post to cause attention again.

　　昨天，在政协会议医卫界小组讨论上，全国政协委员、卫生部副部长黄洁夫公开回应这位医生网友。黄洁夫坦言，“如果基层医生对医改如此困惑和沮丧,中国的医改就无法成功”，并指出，在没有具备“全民免费医疗”条件前，“先看病后付费”不宜全面推行。

yesterday,On the YiWeiJie panel discussion of CPPCC,The CPPCC national committee/Deputy health minister huang jiefu netizen public response to the doctor.Huang Jiefu admitted,"If the doctor is so confused and frustrated to reform at the local level,China's health care reform will not be able to succeed",And point out that,When there is no have"The free medical care"Condition before,"To see the doctor before they are paid"Not fully implementing.

　　靠财政搞“医药分开”难长久 Rely on finance to make"Medicine separately"Hard for a long time

　　黄洁夫表示，由于我国对医疗服务长期存在不合理的价格管制，大部分医疗服务定价并未考虑人力成本，医生劳动价值得不到合理体现。在扭曲的价格体制下，公立医院以药养医和检查收费成了普遍的补偿机制。北京有多家医院在尝试支付体制改革，试行医药分开。黄洁夫说，这是一项有意义的改革尝试，但政府财力是有限的，单纯用财政去补贴医院因取消药品加成造成的损失难以长久。

Huang Jiefu said,Because our country long-standing unreasonable to the medical service price controls,Most of the medical service pricing does not take into account the human cost,The doctor labor value is not reasonable.Under the distorted price system,Public hospital medicine for the medical and inspection fees become common compensation mechanism.There are hospitals in Beijing trying to pay system reform,Try out medicine separately.Huang Jiefu said,This is a meaningful attempt at reform,But the government financial resources are limited,Use the financial losses caused by cancellation of drug addition to subsidize hospital for a long time.

　　“无论是政府还是公立医院本身，都难以用过去行之有效的计划手段来配置医疗资源。”黄洁夫认为，如果没有一个符合当前医疗市场运行规律的医保支付制度综合改革，很难形成一个合理的医院补偿机制。黄亦坦言，公立医院改革前景尚不明朗。

"Both the government and public hospital itself,Are difficult to use effective means to configure the medical resources in the past."Huang Jiefu think,If no one obeys the law of the current medical market operation comprehensive reform of medicare payment system,It is difficult to form a reasonable compensation mechanism for hospital.Huang also said,Prospects for reform of public hospitals is unclear.

　　“先看病后付费”难大范围推行 "To see the doctor before they are paid"To a wide range

　　最近，媒体报道引发公众关注的“先看病后付费”能否全面推行？黄洁夫说，在没有具备“全民免费医疗”条件前，“先看病后付费”不宜全面推行。他以英国的全民卫生服务为例，“由于操作不当产生社会福利病，造成财政负担过重，福利过滥，最后受害的还是老百姓”。

recently,Media reports caused public concern"To see the doctor before they are paid"Whether it can fully implementing?Huang Jiefu said,When there is no have"The free medical care"Condition before,"To see the doctor before they are paid"Not fully implementing.He in Britain's national health service, for example,"Social welfare disease due to improper operation,Due to the heavy financial burden,Welfare surplus,The last victims or the people".

　　黄洁夫说，事实上，现在的医改，要钱找财政，医保支付要找人社部门，要编制找编办，价格得找物价局……卫生部门其实只是负责卫生事业的一个技术部门，具体进行医改时，更多地只能依靠真正掌握实权的其他各级政府部门，如果无法取得共识，“先看病后付费”只能是在卫生部主管的新农合基金“先行垫付，及时结算”框架下，作为县级公立医院或乡镇卫生院改善医疗服务流程，方便农民就医的一项措施，无法在全国范围内，特别是城市大医院实施。

Huang Jiefu said,In fact,,Now the reform,Want money for fiscal,Medicare pays for social sector,To prepare for the public sector,Prices have to find price bureau...The health department is just a technical department responsible for health,Specific for health reform,More can only rely on the real power of other government departments at all levels,If you cannot agree,"To see the doctor before they are paid"Only in the ministry of health director's new agricultural funds"First advances,Timely settlement"Within the framework of,As a public hospitals at the county level or in towns and townships to improve the medical service process,A measure of the medical treatment easy farmers,Not on a national scale,Especially big city hospital.

代表观点 On behalf of the views

　　公立医院应剥离“特需” Public hospitals should be shed"The special"

全国人大代表钟南山称，医改首先应明确不同医院定位；呼吁国家重视全科医生 Deputy to the National People's Congress zhong said,Health reform should first clear positioning different hospital;Calls for the country attaches great importance to the gp

　　昨天，全国人大代表钟南山在驻地举办小型记者会。这位以直言闻名的医生、院士也在关注医改，思考公立医院改革路径，他呼吁国家重视全科医生、重视乡村医生，“加强基层医疗卫生服务网点，让患者从大医院有效分流，而不是扩张大医院”。

yesterday,The National People's Congress held a small press conference zhong in the station.The outspoken famous doctors/Academician and focusing on health care reform,Thinking path to the reform of public hospitals,He called on countries attaches great importance to the gp/Attaches great importance to the rural doctors,"Strengthen the grassroots health service network,Let patients from hospitals effective shunt,Rather than the expansion of large hospitals".

　　公立医院应剥离“特需” Public hospitals should be shed"The special"

　　谈到公立医院改革，钟南山坦言，中国目前还没有真正的公立医院。中国公立医院其实是公办民营医院。

When it comes to the reform of public hospitals,Zhong said,There is no real public hospitals in China.Chinese public hospitals are public private hospitals.

　　“没办法，财政投入太少，大概只占医院运行成本10%左右，医院只能想办法赚钱才能生存。”钟南山说，现在公立医院改革非常矛盾。降低药价，责任制，甚至要“医药分家”、药品零加价，增加医事服务费。“在政府没有形成长效的补偿机制情况下，取消药品加价，医事服务费收上去，不还是一样没减轻患者负担吗？”

"No way to,Financial investment is too little,Probably only hospital operating costs accounted for about 10%,Hospital only to find a way to make money to survive."Zhong said,Reform of public hospitals is now very contradiction.Lower drug prices,Responsibility system,Even want to"Medicine separation"/Drugs zero tariffs,Increasing medical service charge."The government has no long-term compensation mechanism,Cancel the drug markup,Medical service charge taken up,Not still the same didn't alleviate patients burden?"

　　钟南山认为，医改首先应明确不同医院的定位。公立大医院的职责是什么？在钟南山看来，首先是解决疑难病；其次要做研究，做好疾病的早防早诊早治；第三，要把下面挂钩的基层医院、基层医生培训好，能够解决常见病、多发病。“可如果把这三条都做好的话，三甲医院病人会大大减少。医院靠什么活？”钟南山自嘲地说。

Zhong think,Health reform should first clear positioning in different hospitals.What is the duty of public hospitals?It seems to zhong,First of all is to solve the knotty;Secondly to do research,Ready as early as the early detection of disease treated early;In the third,Basic-level hospitals to link below/Doctors at the grass-roots level training,Able to solve common diseases/Frequently-occurring disease."But if all these three words,3 armour hospital patients will be greatly reduced.What do live hospital?"Zhong said wryly.

　　但钟南山也表示，公立医院改革需要一个过程，“因为中国太大了，每家公立医院都要政府出那么多钱，确实困难”。“但方向一定要坚定：公立医院一定要逐渐增加公益性，剥离特需服务。”钟南山说，在国际上，特需医疗服务，都是由高端的私立医院来做；中国的特需医疗服务，也须由正规的民营医院承担起来。

But zhong said,Reform of public hospitals needs a process,"Because China is too big,Each public hospital is the government so much money,Really difficult"."But the direction must be determined:Public hospitals must gradually increase public welfare,Stripping the special service."Zhong said,In the world,The special medical services,Is done by high-end private hospitals;The special medical services in China,Also shall be borne by the formal private hospitals.

　　“医改要注重人的培养” "Health should pay attention to the cultivation of the people"

　　如何破解群众看病贵、看病难？钟南山认为，医改中，应把全科医学放在非常重要位置，“我非常热衷壮大全科医生队伍”，钟南山说，全科医学搞好了，很多问题都可以迎刃而解。由全科医生构建的基层卫生服务网络一旦运行顺畅，将解决大医院看病贵看病难的问题。

How to crack the crowd to see a doctor expensive/The doctor is difficult?Zhong think,In the reform,Should be put in very important position in general medicine,"I am very keen to expand gp team",Zhong said,Do a good job in the general medicine,Many problems can be solved.By the GPS once build grassroots health service network running smoothly,To solve the problem of big hospital to see a doctor expensive medical care.

　　全科医学是非常系统的医学门类。在钟南山看来，现在，我国的全科医生还不太“全”。“能看常见病，还要能知道患者病情发展后，须要转到大医院的哪个科”，钟南山说，不要以为这些问题大医院的专科医生能解决。“全科医生对专科医生将来是极大的促进。”

Is a system in general medicine medical departments.It seems to zhong,now,Gp is not particularly in our country"all"."Can see common diseases,Also can know patients after illness development,Need to go to large hospital which section",Zhong said,Don't think that big hospital of specialized subject doctor can solve these problems."Gp to a specialist in the future is a great boost."

个案 case

　　青海省长：住院后结算没发生欠账 Qinghai provincial governor:Hospitalized after the debt settlement did not occur

　　新京报讯 （记者王姝）截至本月，青海省“先住院后结算”制度已实施5月。昨日，在青海团媒体开放日现场，青海省省长骆惠宁表示，迄今为止，“先住院后结算”制度未发生一起恶意欠账事件。

Beijing - (The reporter Wang Shu)By the end of this month,Qinghai province"In hospital before settlement"System has been implemented in May.yesterday,At the scene of the QingHaiTuan media Open Day,Qinghai provincial governor luo huining said,So far,"In hospital before settlement"System no malicious default incident happens.

　　自去年9月起，青海省开始在省、州(市)、县、乡四级公立医院，推行“先住院后结算”，即住院时不用交押金，出院时只需结清自付费用。享受上述待遇的不仅包括有医保和新农合的城镇职工、农民，而且还包括无姓名和居住地等身份证明的“三无”病人。

Since last September,Qinghai province began in the province/state(The city)/county/Village-level public hospitals,push"In hospital before settlement",Don't have to pay the deposit when that was in the hospital,Only when the discharge settlement of out-of-pocket expenses.Enjoy the treatment not only include health care and new farming and urban workers/farmers,But also without name and certificate of residence, etc"3 without"The patient.

　　骆惠宁说，由于“先住院后结算”实施效果良好，所以今年将扩大范围。此外，今年，青海将打通城镇职工医保和新农合医保，即统一城乡医保标准。

Luo huining said,Due to the"In hospital before settlement"Implementation effect is good,So this year will expand the scope.In addition,This year,Qinghai will get through medical insurance for urban employees and new farming and health care,The unified urban and rural health care standards.

　　采写（除署名外）/新京报记者 魏铭言

Writing and(In addition to the signature)/ w MingYan Beijing news reporter