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公立医院综合改革下半年全面推开 破除“以药补医”

2017-07-26 01:49:20   经济参考报

据统计,截至2016年年末,全国三项基本医保参保(参合)人数达13.4亿,参保率达98.8%,连续五年完成参保率稳定在95%以上的年度任务。城乡居民医保整合地区人均筹资标准达620.4元;未整合地区城镇居民医保人均筹资标准达570.2元,新农合统筹地区人均实际筹资达551.4元。10个省份实现大病保险省级统筹,334个地市(占99%)实施了疾病应急救助制度。2012年,人均基本公共卫生服务经费为25元;2017年,人均基本公共卫生服务经费提高到50元。

另一方面,近5年来,我国医改持续深入推进。人民健康水平持续改善,居民主要健康指标总体上优于中高收入国家平均水平,人均期望寿命从2010年的74.83岁上升至2016年的76.34岁。北京大学医学部公共卫生学院教授吴明认为,我国在短时间内建立起覆盖全民的基本医疗保障制度,筹资水平和政府投入逐年提高,在改善居民医疗服务可及性、解决看病贵问题上发挥了关键作用。

从中央到地方,国家对医改投入巨大的人力、物力和财力,全民医保体系取得了非常大的进展。国家卫计委监察专员姚建红对《经济参考报》记者表示:“十多年前,我们国家的医保相对比较欠缺,那时经常有一句话,叫‘小病拖大病扛,实在不行见阎王’,这个情况已经得到很大改变,这要归功于医保制度的大幅建设。在目前经济下行的情况下,从中央到地方政府,对医保方面依然大量投入,这充分体现了政府对民生的高度关切,人民群众也享受到了医改的获得感。”

另一方面,我国医疗服务体系也有了十足的进步,遍布城乡的医疗卫生机构已覆盖每个角落。“在我们960万平方公里的土地上,只要有人的地方,我们通过多种方式,都力争把医生和医疗服务送到百姓身边。”姚建红说,反过来讲,医疗服务体系有进步了,老百姓就更愿意去医院。2008年全国诊疗量是49亿人次,截至2016年底上升到79亿多人次,增长速度超过60%。基本医保保障水平逐步提高,为实现人人病有所医提供了制度保障。

此外,大病保险从无到有,夯实了基本医保制度。2012年,我国开始试点城乡居民大病医疗保险制度。到2016年底,城乡居民大病保险全面推开,实现全覆盖。2016年,全面实施重特大疾病医疗救助,救助对象范围从城乡低保对象、特困人员逐步拓展到农村建档立卡贫困人口、低收入救助对象和因病致贫家庭重病患者。

我国在医疗保障领域的成就获得了国际广泛认可。世界银行、世界卫生组织报告指出,我国在实现全民健康覆盖方面迅速迈进,医改成就举世瞩目,

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