从“人人享有” 到“人人公平享有”.pdfVIP

观察思考 从“人人享有”到“人人公平享有” ——社会医疗保险需要解决四大问题 何文炯 （浙江大学 杭州 310027） 【摘要】 我国社会医疗保险正在由制度全覆盖走向人员全覆盖，下一个目标将是从“人人享有”走 向“人人公平享有”。本文认为，实现这一目标，需要解决四大问题：一是树立公平理念，逐步缩小人 群之间、城乡之间和区域之间的社会医疗保险待遇差别，保障社会成员基本医疗需求；二是优化制度设 计，增强社会医疗保险制度的公平性、可持续性和制度运行效率；三是完善体制机制，理顺经办和管理 体制，健全筹资、待遇调整和结算机制，深化医疗卫生和药品流通体制改革；四是提高服务水平，做到 方便、快捷、优质、高效。 【关键词】 社会医疗保险；公平 【中图分类号】 文献标识码 文章编号 F840.684 C913.7 【 】 A 【 】1674-3830(2012)1-13-4 doi:10.369/j.issn.1674-3830.2012.1.3 Social Medical Insurance from “For All” to “For All With Equity”——4 Issues to Address in Social Medical Insurance Wenjiong He (Zhejiang University, Hangzhou,310027) 【 】Current social medical insurance system has already covered all social classes theoretically. Abstract Next objective is that social medical insurance should be from “for all” to “for all with equity”. This paper maintains that four problems must be solved to achieve this goal. First, we should set up the concept of equity, and lessen the difference of social medical insurance treatment between the city and countryside, among various persons and regions. Then the basic medical requirement of all members can be guaranteed. Second, we should optimize the system to increase the equity, sustainability and the operational efficiency. Third, we should improve the systems (especially the transaction services and management systems) and mechanisms (especially the fund- raising, treatment adjustment and settlement mechanisms). We also should continue to reform the medical and public health systems and the pharmaceuticals production and distribution system. Last, we should ma