四部门负责人谈医改 国家财政四年投入医改6800亿 Four head of talk about reform national finance in health care for four years. 680 billion

　　

全国基本药物价格平均降30% The national essential drugs prices fall by an average of 30%

　　医改事关千家万户，也历来是全国“两会”媒体关注的焦点。昨天，国家发改委副主任、国务院医改办主任孙志刚；卫生部副部长、国务院医改办副主任马晓伟；人社部副部长、国务院医改办副主任胡晓义；财政部副部长、国务院医改办副主任王保安就“医药卫生体制改革”的热点问题回答中外记者提问。据介绍，医改启动四年以来，国家财政已投入6800亿元，下一步医改工作的重点是建立补偿机制，同时改革支付方式，去除过度医疗的制度性诱因，今年医保总支出预计超过1万亿。

Health care is a matter of households,Also has always been throughout the country"The two sessions"The focus of media attention.yesterday,Deputy director of the national development and reform commission (NDRC)/Sun zhigang, director of the healthcare reform office of the state council;Vice minister of health/Health under the state council, deputy director of Mr. Ma;One club vice minister/Health under the state council, deputy director of Hu Xiaoyi;Deputy minister of finance/Wang Baoan is deputy director of the health office of the state council"Medical and health system reform"The hot issue of answer questions from Chinese and foreign journalists.According to introducing,Health reform started in four years,National finance has invested 680 billion yuan,The focus of the reform is to establish compensation mechanism,At the same time reform of payment,Remove the excessive medical treatment institutional incentives,Health-care spending is expected to more than 1 trillion this year.

　　

大量人力物力资金投向基层 A large number of manpower and money at the grass-roots level

　　发改委副主任孙志刚在发布会上表示，中国的医改是从中国的国情出发，在实现路径上坚持了从基本入手、从基层改起。“我们从最薄弱的环节改起，把大量的人力、物力、资金投向基层，满足群众在基层看病就医的需求，使人民群众尽快享受到改革带来的实惠，从而从内心里支持和拥护改革。”

Sun zhigang, deputy director of NDRC, said at the news conference,China's health reform from China's national conditions,Stick out from the basic on the paths/Since grassroots change."We from the weakest link,Put a lot of manpower/Material resources/Money at grassroots,Meet the needs of mass in the grass-roots hospital,Make the people enjoy the reform bring benefit as soon as possible,Thus from the inside to support and embrace change."

　　孙志刚强调，在重点突破上，我国坚持把体制机制创新放在突出的位置。“始终把破除‘以药补医’机制、建立新的运行机制作为重点，用投入来促进改革，用新的投入换来新的机制，使基层广大医务工作者亲身体会到条件的改善、待遇的提高是改革带来的，是新的体制机制带来的，从而从内心里支持改革，积极地参与到改革中去。”

Sun zhigang stressed,On the breakthroughs made in key areas,Keep your institutional innovation on the prominent position in China."Always put the break‘With medicine cure’mechanism/To set up new operation mechanism as the focus,With input to promote reform,With the new investment for new system,Make the grass-roots masses of medical workers experience to improve conditions/The improvement of treatment is to reform,Was brought by the new system and mechanism,Thus from the inside to support reform,Actively participate in the reform."

　　

支付方式改革是核心内容 Payment method reform is the core content

　　提到公立医院改革，卫生部副部长马晓伟透露，目前全国已有22个省、431个县级地区公立医院完成了取消药品加成，17个省对试点地区的医疗服务价格进行了全面调整。有27个省开始了支付方式的改革，还有地区在推进先诊疗后付费。

Reform of public hospitals,Deputy health minister ma xiaowei said,Now has 22 provinces throughout the country/431 areas at the county level public hospital to complete the cancellation of drug addition,17 provinces to comprehensive pilot areas of the medical service price adjustment.There are 27 provinces started the reform of the payment,And areas in promoting the diagnosis and treatment before they are paid.

　　马晓伟介绍，下一步医改工作的重点就是建立补偿机制，加大政府财政对公立医院的投入以及对政策性亏损的补贴，同时改革支付方式。“支付方式改革是核心内容。”马晓伟说，为改变医疗机构和患者之间信息不对称状态，购买服务的格局必须由第三方去监管，必须改变现在这种项目加成的办法，去除过度医疗的制度性诱因。“要采取以总额预付、病种管理、按人头付费等多种形式的付费方式，方式根据医院水平、规模情况而定。总之，要通过医保，加大对医疗机构的约束和激励。”

Mr. Ma is introduced,The focus of the reform is to establish compensation mechanism,Increasing government financial investment in public hospitals and subsidies for practies,At the same time reform of payment."Payment method reform is the core content."Ma xiaowei said,To change the state of asymmetric information between medical institutions and patients,Purchasing service pattern must be regulated by a third party,Must change this project bonus way now,Remove the excessive medical treatment institutional incentives."Take total in advance/Disease management/Capitation payment, and other forms of payment,Methods according to the level of hospital/Size of the case may be.All in all,To pass health care,Constraints and incentives for medical institutions."

　　“在监管机制当中应注意到，医院内部的监督管理和补偿机制有关系，如何建立一个符合医生职业特点的，以医疗的数量、质量、风险程度以及患者的满意程度为标志的，以公益性为核心的薪酬支付制度，是我们这次改革一个很重要的方面。”

"Should pay attention to in the middle of the supervision mechanism,Hospital internal management and the supervision of compensation mechanism,How to establish an accord with the characteristics of professional,To the number of medical/The quality/Degree of risk, and the patient's satisfaction with the marked,With public welfare as the core of compensation payment system,We are a very important aspect of the reform."

　　

国家财政投入医改6800亿 National finance in health care, 680 billion

　　财政部副部长王保安昨天透露，医改启动四年以来，国家财政共投入6800亿元，其中中央财政拿了近3000亿。这些投入主要用于支持新农合、城镇居民医疗保险制度的建立，支持解决关闭破产企业退休人员和困难企业职工的参保问题，也支持扩大了医疗救助范围，提高救助水平。

Deputy finance minister Wang Baoan revealed yesterday,Health reform started in four years,National finance has invested 680 billion yuan,With the central government took nearly $300 billion.The investment is mainly used to support the new farmers/The establishment of the system of medical insurance for urban residents,Support solution to close the bankrupt enterprise retiree company worker the ginseng of problems and difficulties,Also supports expanded the scope of medical aid,Improve the level of assistance.

　　同时，在医改前三年攻坚期间，中央财政拿出120亿进行补助，支持建立了基本药物制度。“从去年开始建立了稳定的补偿机制，每年拿91亿，其中21亿是用于支持村医的基本药物制度的实施。 ”王保安说，“国家财政投入还主要用在建立了基本公共卫生服务的均等化体系，并且不断快速提高标准，在这方面花了1300多亿。 ”

At the same time,In the three years preceding the reform crucial period,The central government took out 12 billion for assistance,Support the basic drug system is established."Since last year the establishment of a stable compensation mechanism,Every year 9.1 billion,2.1 billion of them were used to support the implementation of the system for basic drugs village doctor. "Wang Baoan said,"State finances are mainly used in the equalization of basic public health service system is established,And constantly improve the standard quickly,In this MianHua more than $1300. "

　　此外，用于基层医疗机构的基本建设投资为1300亿元，重大设备购置和改造维修等。“除了硬件，还有乡镇卫生院招聘医师、万名医师支援农村、定向医学生的培养等软件建设。”同时，支持实行医疗工作者的绩效工资制度，每年补贴16亿。“在支持公立医院改革方面，累计投入了800亿，同时启动县级公立医院的改革试点，去年启动了311个县，每个县先给300万，去年花了9.3个多亿。

In addition,Used in grassroots medical institutions of the basic construction investment is 130 billion yuan,Major equipment purchase and maintenance, etc."In addition to the hardware,And in towns and townships recruiting physicians/Thousands of doctors support in rural areas/Construction of directional cultivation of medical students and other software."At the same time,Support for health workers performance wage system,Subsidies to 1.6 billion each year."In support of public hospital reform,Accumulative total investment 80 billion,At the same time start the trial reform of public hospitals at the county level,Last year launched the 311 counties,Each county to 3 million,Spent more than $9.3 last year.

　　

17万家药店是医保监管重点 17 m pharmacy is a medical insurance regulatory focus

　　近年来，欺诈骗保行为也时有发生。胡晓义表示，目前相关部门已经联手打击骗取、套取、诈骗医保基金的行为，但小药店仍是相对薄弱的环节。

In recent years,Fraud in insurance fraud behavior also happen from time to tome.Hu Xiaoyi said,At present related departments have joined forces to fight to defraud/To obtain/Fraud behavior of medical insurance fund,But little pharmacy is still a relatively weak link.

　　胡晓义说，目前我国医保体系覆盖总数已经超过13亿人，医保基金的规模也不断增长，去年三项医保总支出大概是9000亿左右，今年预计超过1万亿。风险很可能来自医保基金的管理者、医保基金支付的对象和少数的参保人员、患者。

Hu Xiaoyi said,At present, China's health care system has covered more than 1.3 billion people,The scale of medical insurance fund is also growing,Three health care expenditure is probably around 900 billion last year,This year is expected to more than 1 trillion.Risk is likely to come from the medical insurance fund management/Medical insurance fund objects and a few of the ginseng protect personnel to pay/In patients with.

　　对于内部人员的廉政和监管，胡晓义说，“最近，人社部专门出台了20条禁令，就是社会保险工作人员的20条纪律规定，划出红线不准跨越。” 对于医院和药店的监管，胡晓义表示，“人社部和卫生部门一起配合，把医保的信息管理网络联到各个地方的服务医院，使每一次的诊疗、每一个处方都能够在网络上运行，得到实时的监控。”但他指出，药店还是一个薄弱的环节。“医疗保险定点的药店有17万多家，而且很多都是小药店，要实现全面的联网监控难度比较大，但是要加大这方面的举措。”

For internal integrity and regulation,Hu Xiaoyi said,"recently,People club department specially introduced 20 ban,Is the staff social insurance article 20 of the disciplinary regulations,To draw the red line is allowed to across." Regulation for hospitals and pharmacies,Hu Xiaoyi said,"People club department and health department together,The health information management network to the service in every region of the hospital,Make every diagnosis and treatment/Each prescription can run on the Internet,Get real-time monitoring."But he pointed out that,Pharmacy is still a weak link."Medical insurance fixed point in the pharmacy there are more than 170000,And many of them are small drugstore,In order to realize comprehensive network monitoring more difficult,But to increase efforts in this regard."

　　对于参保人、患者的监管，胡晓义表示，目前已经和公安等多部门联手打击骗取、套取医保基金的犯罪行为，而且要进一步加强监管力度。

To join/Regulation in patients with,Hu Xiaoyi said,At present already and the public security departments to combat cheating more/Show the crime of medical insurance fund,And to further strengthen supervision.

　　

基层医院药价均降三成 Grass-roots hospital drug prices were down thirty percent

　　实行基本药物制度之后，全国基层医疗卫生机构使用的基本药物价格平均下降了30%。孙志刚谈到医改成效时表示，到2015年基层医疗卫生机构达标率达到95%以上。

A system for basic drugs,Grass-roots medical institutions across the country use basic drug prices fell by an average of 30%.Sun zhigang said when it comes to health care effect,To the grassroots health institutions in 2015 success rate reaches more than 95%.

　　孙志刚说，“改革前，新农合和城镇居民医保政策范围内的报销比例大致在50%左右，现在新农合超过了75%，城镇居民医保达到了70%，有的地方已经达到80%。”同时，通过医改，基层医疗卫生机构的服务能力有了明显提高，基层卫生医疗机构的硬件设施、软件设施都有了明显的改善。

Sun zhigang said,"Before the reform,New farmers and urban residents medical insurance policy within the scope of reimbursement ratio is roughly around 50%,New farming and more than 75% now,Urban residents coverage reached 70%,In some places has reached 80%."At the same time,Through reform,Grassroots medical institutions of service capacity has increased significantly,The hardware facilities of grassroots health institutions/Software facilities have improved.

　　孙志刚透露，“实行基本药物制度之后，全国基层医疗卫生机构使用的基本药物价格平均下降了30%，有的地方下降得更多。”他举例说，自己在安徽的一家乡镇医院遇到一对老年夫妇在那里看病，“他们告诉我，同样的药改革前是234块，改革之后是83块，而且还有相当一部分可以报销。”

Sun zhigang said,"A system for basic drugs,Grass-roots medical institutions across the country use basic drug prices fell by an average of 30%,In some places down even more."For example, he said,He encountered in a township hospitals in anhui an elderly couple in there to see the doctor,"They told me,Before the same medicine reform is RMB 234,After reform is RMB 83,And there are quite a number of you can submit an expense account."

　　

统一社保卡推进异地报销 Unified social security card to promote long-distance expenses

　　在回答关于异地就医报销的问题时，胡晓义坦承，解决这个问题，还需要政策的完善，并要大力推进统一的社会保障卡。

In response to questions about the long distance medical reimbursement,Hu Xiaoyi admitted,To solve this problem,You also need to the improvement of the policy,And to promote the unity of the social security card.

　　胡晓义说，全国跨省转移是未来的目标，但是还有一段相当长的路要走。“首先是医疗机构分布的结构问题，大家知道最好的医疗资源就在中心城市、特大城市，但是不能让所有的人都到中心城市、特大城市看病，所以整个制度安排还是鼓励小病在基层看、在本地看，有疑难杂症、重大疾病到中心城市来看。”此外，还要重点解决异地安置的退休人员，他们长期在异地居住，医保报销如果每次都要回原地的话就比较复杂，所以需要把他们作为重点。

Hu Xiaoyi said,The national cross-regional transfer is a target for the future,But still have a long way to go."The first is the structure of the distribution of medical institutions,As we all know the best medical resources in the central city/megacities,But can't let all people to the city center/Megacities to see the doctor,So the whole institutional arrangement or encourage ailment at the grassroots level/In local,Have a incurable diseases/Major diseases to the center city."In addition,Will focus on relocated retirees,Their long-term living in different places,Reimbursement if every time to back on the ground is more complicated,So you need to put them as the key.

　　胡晓义表示，为此要统一全国的信息管理系统，大力推进统一的社会保障卡。“在2010年，统一社会保障卡的发行只有1.03亿张，到现在为止已经发到了3.5亿张，今年要达到4.8亿张。”

Hu Xiaoyi said,Need a unified information management system of the whole country,Promote the unity of the social security card."In 2010,,The issue of unified social security CARDS only 103 million copies,Up to now have been sent to 350 million copies,This year to reach 480 million."

　　

药价无加成不影响医院运转 Price no bonus will not affect the hospital operation

　　王保安表示，基层医疗卫生机构实施国家基本药物制度后，没有出现“药价的负担减了半斤、其他的负担却加了八两”的情况，药价加成取消不会影响基层医疗卫生机构正常运转。

Wang Baoan said,Grassroots medical institutions after the implementation of the national system for basic drugs,Does not appear"The burden of drug prices lost half a kilo/The other eight two burden was added"In the case,Prices in addition to cancel will not affect the normal running basic-level medical health agency.

　　王保安说，为了保障基层医疗卫生机构实施国家基本药物制度后能够正常运转，首先提高了医疗服务价格，实施一般诊疗费。“通过医保报销了一般诊疗费的大约90%，个人负担也就是10%左右，与原来相比，没有增加个人负担。”第二，财政采取了专项补助措施，保证实行基本药物制度后，能够使基层医疗卫生机构正常运转，有序发展。“第三，兜底措施，一旦出现总的收支差额，财政将给予足额的补偿。”

Wang Baoan said,In order to ensure grass-roots medical institutions after the implementation of national essential drug system can run properly,First of all, raise the price of medical services,Implementation of the general fee."Through the general coverage fee of about 90%,Individual responsibility is about 10%,Compared with the original,No burden on individuals."In the second,Fiscal special subsidies measures were taken,Guarantee shall practise a system of basic drugs,Can make the grass-roots medical institutions run properly,Orderly development."In the third,Out measures,Once appear, the total balance,Finance will give full of compensation."

　　王保安还表示，在财政专项补助措施中，“人均标准正在提高，由过去的15块提高到今年的30块了，到2015年要到人均40块以上。”(记者 王萍)

Wang Baoan also said,In the special financial subsidy measures,"Per capita standard is improving,From past $15 to 30 of this year,In 2015 to more than 40 yuan per capita."(Reporter wang ping)