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深化医改:城乡居民医保年内完成并轨

2017-05-12 10:50:36   经济参考报

原标题:深化医改:城乡居民医保年内完成并轨

原标题:筹资待遇范围全部实现统一 城乡居民医保年内完成并轨

理顺管理体制,开展医保基金管理中心试点

城乡居民医保将于年内完成并轨。日前,国务院办公厅印发《深化医药卫生体制改革2017年重点工作任务》(以下简称《工作任务》),要求着力推进分级诊疗、现代医院管理、全民医保、药品供应保障、综合监管5项制度建设,不断推动医改向纵深发展。国家卫计委5月11日召开新闻发布会,介绍2017年深化医改重点工作任务。

目标 城乡医保年内完成整合

2003年和2007年,我国针对农村人口、城镇非就业人口分别建立了新农合和城镇居民医保制度。不过此后,两项制度城乡分割的弊端逐步显现,重复参保、重复投入、待遇不够公平等问题日益突出,不仅增加政府的管理成本和负担,而且不利于社会公平和人员流动。不仅如此,在制度整合前,城镇职工医保、城镇居民医保两项制度是由人社部来管理,而新农合则是由卫计委管理,徒增巨大成本,更增加了协调难度。

上述《工作任务》明确,2017年完成城乡居民基本医保制度整合,实行覆盖范围、筹资政策、保障待遇、医保目录、定点管理、基金管理“六统一”政策。理顺管理体制,可开展设立医保基金管理中心试点,承担基金支付和管理,药品采购和费用结算,医保支付标准谈判,定点机构的协议管理和结算等职能。

《经济参考报》记者了解到,目前已经有超过20个省份实现了城乡居民医保并轨,由于并轨实行报销范围“就高不就低”的原则,城乡居民待遇普遍提高,不少地区用药目录得到大幅扩容。

此外,城乡医保制度整合后,城乡居民不再受城乡身份的限制,医保管理服务实现了一体化,人社部数据显示,仅山东一省整合就剔除重复参保250万人,当年节约财政重复补助资金8亿多元。

“通过整合医保基金、统一定点管理,参保居民可以享受到城乡一体化的经办服务,城乡居民医保关系转移接续也会更方便。”中央财经大学保险学院教授褚福灵对记者表示。

清华大学公共管理学院教授杨燕绥也表示,“建立统一的城乡居民医保制度后,增强了医保基金的互助共济能力,有利于发挥医保对医改的基础性作用,促进医保对医疗服务的外部激励制约,为‘三医联动’改革打下了坚实基础。”

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