“实现统筹城乡的居民医保制度的最终目标是要建立覆盖城乡非就业居民、与统筹地区经济和社会发展水平相适应、权利与义务相对等的缴费型医疗保险模式，为最终实现“全民医保”和社会医疗保险制度框架的统一奠定基础。”7日，全国人大代表郭新志在接受中国经济网记者采访时说。

"To realize overall urban and rural residents's ultimate goal is to build a new health care system covering urban and rural residents of employment/And as a whole the area corresponds to a level of economic and social development/The rights and obligations of payment type medical insurance mode,To achieve"Universal health care"And laying a foundation for the unity of the social medical insurance system framework."7,The National People's Congress Guo Xinzhi told China JingJiWang reporter in an interview.

　　全国人大代表郭新志。资料图

The National People's Congress Guo Xinzhi.Material chart

　　郭新志代表在其提案《关于统筹城乡居民医保的建议》中表示：目前山西山西省城镇居民医保和新农合参保(合)人数已覆盖全省人口的三分之二，是山西省社保体系的重要组成部分。但由于国家政策体系、管理部门(城镇居民医保由人社部门管理，新农合由卫生部门管理)尚未统一，山西省两个社会保险仍处在“各自为政”的状态，已经成为推进山西省城乡统筹发展和体制机制创新的制约因素之一。

Guo Xinzhi representatives in its proposal[Suggestions for overall urban and rural residents health]In the said:At present in shanxi Shanxi Province urban residents medical insurance and new farmers ginseng protect(us)The number has covered two-thirds of the province's population,Is an important part of social security system in Shanxi Province.But due to national policy system/Management department(Urban residents health care by people club department management,New farming and management by the health department)Has yet to be unified,Two social insurance is still in Shanxi Province"fragmented"state,Has become a promote the harmonious development between urban and rural areas in Shanxi Province and one of the factors of system and mechanism innovation.

　　因此，郭新志代表在其提案中提出了两点建议：

so,Guo Xinzhi representative in its proposals put forward two Suggestions:

　　首先，需要统一制度框架。郭新志代表认为国家有关部门改善“顶层设计”，实现统筹城乡的居民医保制度的最终目标是要建立覆盖城乡非就业居民、与统筹地区经济和社会发展水平相适应、权利与义务相对等的缴费型医疗保险模式，为最终实现“全民医保”和社会医疗保险制度框架的统一奠定基础。

First of all,The institutional framework needs to unity.Guo Xinzhi represents that the relevant state departments to improve"The top design",To realize overall urban and rural residents's ultimate goal is to build a new health care system covering urban and rural residents of employment/And as a whole the area corresponds to a level of economic and social development/The rights and obligations of payment type medical insurance mode,To achieve"Universal health care"And laying a foundation for the unity of the social medical insurance system framework.

　　制度设计在定位上应体现“统筹”和“保险”两个基本特征，在制度模式的选择上应尽量向城镇职工医疗保险靠拢，同时要充分考虑各地经济发展水平和财政承受能力，保证制度的可持续发展。考虑到不同人群缴费能力的不同，在基本医疗风险得到公平保障的前提下，制度设计可以保留一定的弹性，允许筹资水平与待遇标准适当挂钩，使得参保者可以根据自己的情况进行选择。

System design should reflect on the positioning"As a whole"and"insurance"Two basic characteristics,On the choice of system model for urban employees' medical insurance should as far as possible to close,At the same time, we must give full consideration to local economic development level and financial capacity,To ensure the sustainable development of the system.Considering the different people different payment ability,In the basic medical fair under the premise of guarantee for risk,System design can retain a degree of elasticity,Allow the funding level with appropriate treatment standard,Make the participants can choose according to their own situation.

　　另外，在制度设计时可以考虑对低收入者或弱势群体的倾斜性财政补贴，以体现公共财政收入再分配的功能。

In addition,Can consider when system design skewed fiscal subsidies for low-income or disadvantaged groups,In order to reflect the public finance income redistribution function.

　　其次，统一经办管理。郭新志表示统一经办管理指将新农合和城居医保制度统一为一个部门主管，同时实现对经办服务的统一机构和统一管理。

secondly,Unified management of orgnaization of.Guo Xinzhi said orgnaization of unified management refers to the new farmers and city health care system in unity as a department manager,And to achieve unified organization and management of orgnaization of service.

　　管理体制的统一最关键的是政府主管部门的统一，从政府职能划分看，人力社保部门作为社会医疗保险的主管部门较为合适。将社会保险统一由人力社保部门管理，有利于社会保障政策的协调统一和管理效能的提高。

The unity of the management system of the most critical is the unity of the competent department of the government,Look from the government function partition,Human social security department as the competent department in charge of social medical insurance is more appropriate.The social insurance unified by the manpower management of social security branch,Is advantageous to the harmonious and unified social security policy and the improvement of management efficiency.

　　医疗保险经办服务的统一既涉及经办机构、定点医疗机构、定点药店的整合和统一，也涉及参保报销、药品和诊疗项目目录、费用控制和结算、经办流程、计算机信息系统、政策宣传等工作流程和规定的统一。

The unity of the medical insurance agency services involve agency orgnaization/The medical establishment that decide a dot/Pharmacy of integration and unity,Also involves the ginseng for reimbursement/Drugs and diagnosis and treatment project directory/The cost control and settlement/Handling process/The computer information system/The unification of the policy publicity work processes and regulations.

　　郭新志代表在其提案中也提到了统筹城乡医保，整合城乡医保经办资源、理顺体制，有利于统一设计城乡居民医保政策，实现城乡居民医疗保险一体化。便于城乡居民能够享受到更公平、更合理、更高的医疗保险待遇。

Guo Xinzhi representative also mentioned in the proposal as a whole urban and rural health care,Orgnaization of integration of urban and rural health resources/Straighten out the system,Is advantageous to the unified design of urban and rural residents medical insurance policy,Realize the integration of urban and rural residents medical insurance.To facilitate urban and rural residents can enjoy more fair/More reasonable/Higher medical insurance treatment.

　　能够减少部门间的扯皮，增强公共服务能力，提高经办服务效率。降低经办成本，节约经办资源。有利于提高农村居民医保的统筹层次，壮大基金规模，增强基金抗风险能力。

Can reduce the wrangling between departments,Strengthen the public service ability,Improve the efficiency of handling service.Reduce the agency cost,Save orgnaization of resources.To improve rural residents health level as a whole,Strengthen the fund size,Enhances the risk resistance ability of the fund.

代表小资料： On behalf of the small data:

郭新志 Guo Xinzhi，女，1956年出生，全国人大代表、山西省残联副理事长、山西省脑瘫康复医院院长、农工党山西省委副主委。(记者 郝红波 专栏微博)

,female,Born in 1956,The National People's Congress/Disabled persons' federation, deputy director of Shanxi Province/Cerebral palsy rehabilitation hospital in Shanxi Province/Vice-chairman of shanxi provincial party committee, vice chairman.(Reporter Hao Gongbo column weibo)