仇冰玉代表：医保职能划归卫生能发挥最大效益 QiuBingYu representative:Health care function most effectively with a health benefit

　　全国人大代表、山东省卫生厅副厅长仇冰玉建议，医疗保险职能划入卫生部门，能够发挥最大效益。

The National People's Congress/Shandong province health department deputy director QiuBingYu advice,Medical insurance functions delimit the health sector,To maximize benefits.

　　国务院机构改革和职能转变方案提出，把城镇职工基本医疗保险、城镇居民基本医疗保险、新型农村合作医疗保险整合由一个部门承担。

Agency under the state council reform and function transformation plan is put forward,The town worker is basic medical treatment insurance/Basic medical insurance for urban residents/The new rural cooperative medical insurance integration by one department.

　　仇冰玉说，这有利于权责一致、行政高效。但整合以后由哪一个部门管理，行政效能才最高，最大程度发挥资金使用效益，群众利益得到最大化保障？在顶层设计时应认真分析，统筹考虑。

QiuBingYu said,This will help with responsibility/Administrative efficiency.But which one department management after consolidation,Administrative efficiency is the highest,Maximizing the efficient use of funds,Maximize safeguard public interests?On the top floor should be careful analysis in design,As a whole to consider.

　　“医保由卫生部门管理优势最大。”仇冰玉认为，医保的调节作用与卫生行政管理有机结合，可以产生叠加效应，更有效控制医院的不合理诊疗行为；在卫生管理过程中及时发

"Health care management advantages by the health department is the largest."QiuBingYu think,Regulating effect of the health care and public health management organic union,Can produce superimposed effect,More effective control unreasonable hospital diagnosis and treatment behavior;In the process of health management in a timely manner

　　现问题，完善医保政策；可以从医保费用的流向及资金使用情况分析卫生管理问题，制定有利于卫生事业发展的政策措施；可以利用医保对医药的调节作用，在药品招标采购中形成价格优

Now problem,Improve the medical insurance policy;Can be used from the flow of health care costs and capital situation analysis for health management problem,Formulate policies and measures conducive to the development of health career;Can make use of health care regulation of medicine,Formed in drug bidding and purchasing price is excellent

　　势，降低药品招标价格；可以适时合理调节不同层级的报销比例，引导群众合理分流就医；可以通过调整医保政策，来促进新技术和适宜技术的推广应用。

potential,Lower drug bidding price;Can timely properly regulate the reimbursement ratio of different levels,Guide the populace to reasonable divergence;Can through adjusting health policy,To promote the popularization and application of new technology and appropriate technology.

　　仇冰玉认为，医保与一般性保险不同，一般性保险一收一支之间，中间环节较小，而医疗保险中间环节庞大复杂，而其效果的好坏恰恰决定于中间环节政策的制定。而由卫生部门管理医保，可以根据需要适时调整卫生政策。

QiuBingYu think,Health care is different from general insurance,General insurance between a closed one,The intermediate links is smaller,And the intermediate links of medical treatment insurance complex,And its effect is good or bad just depends on the politics of the intermediate links.While the health care health sector management,Can according to need to adjust health policy.

　　卫生部门管理医保会否存在“既是运动员又是裁判员”的问题？仇冰玉说，卫生部门的职责是为群众提供卫生服务、保障群众健康，管理的对象是医院，目的与医保是一致的。

Will medicare health sector management"Both athletes and referees"The problem of?QiuBingYu said,Health department's responsibility is to provide health services for the masses/Protect the health,Management of the object is the hospital,Purpose is in line with the health care.

　　只要加强监管，能够保证资金使用的安全和高效。从世界各国情况看，绝大多数国家的医保职能都在卫生部门。

As long as to strengthen supervision,Can ensure the safety and high efficiency of capital use.Look from the countries of the world situation,The vast majority of the nation's health care function in the health sector.

　　“改革不能简单地合并同类项，否则，精减的是机构，得到的是低能低效，受损的是群众的利益和事业的发展。”仇冰玉建议，成立由多专业组成的专家组，对几种医疗保险运行模式进行综合考核评价，提出最佳管理模式。(记者 王海鹰 娄辰)

"Reform cannot simply combine the like terms,otherwise,Streamline the institutions,Get is inefficient,Damage is in the interests of the masses and the development of my career."QiuBingYu advice,Established by expert group composed of more than professional,Comprehensive evaluation of several kinds of medical insurance operating mode,Best management model is put forward.(The reporter Wang Haiying LouChen)