The medical insurance of Guangdong Province should not be popularized in the whole country to reform

The medical insurance of Guangdong Province should not be popularized in the whole country to reform
The final scheme of the new medical reform has not been issued yet, but the regional medical reform pilot project has been already going on quietly. The medical insurance paid the system to reform as one of the important links of the new medical reform, in the small pilot project of Guangdong Province a few days ago.
March 23, whom the intersection of Guangzhou and municipal Labour Insurance Bureau, Bureau of Finance, health bureau release jointly revise, " whether Guangzhou the intersection of city and social medical insurance hospitalization cost close the method " ' Call " method " in the following text) . According to this method, the medical insurance of Guangzhou can be expected to adopt " single number " to some number within this year Settlement way.
The expert reveals to this newspaper, " single number " Settling account has already written into the public hospital and reformed the instruction in fact, it is expected to become one of the important directions in which public hospital impatient's medical insurance pays the system reform. But the business people in the industry says, the way of this settlement is expected to standardize the hospital to purchase and sell links, eliminate unstandard enterprises, it is useful to medical industry's long-term development.
" single number " Settle account to write into the medical reform
According to " method ", " single number " Settle the special norm of making a diagnosis of the way to some, treat more unanimous number of the expenses, calculate alone the average expense limit standard is settled. This kind of settlement stipulates the project of making a diagnosis needing to provide for patient clearly, join the sponsor's payment proportion clearly at the same time, and does not have one pair of lines.
"This was required by a public hospital reform instruction too, but one of the requirements of the new medical reform. In fact, new the overall scheme of the medical reform have not announced, in fact, we have many (the pilot project of the reform) Go on, so scheme announce or not, there is no very much loud influence to concrete implementation. " If Vice Chief of Guangdong Province department of public health Liao XinBo says to the reporter.
Liao XinBo thinks, the way of this settlement is beneficial to the hospitals and medical insurance organizations: "Except can form the tied mechanism of both sides, social insurance department and hospital can follow situation and medical situation of technical development of economic development ' Understanding of disease) in other words ,Carry on a modification every one to two years, and then come to check and calculate paying. Science, reasonable and humanization this, price, change. "
The reporter knows, Guangdong is only pilot project " single number " in limited number at present Settling account, the personage of local hospital circle says frankly " a normal single number settlement is very easy to push to the reporter open ", but to some more complicated number, it is greater to want the pilot difficulty " .
China's medical insurance Deputy Chairman of research association and concurrently general secretary Xiong XianJun thinks when being interviewed by reporter of " economic newspaper of medicine ": "Suitable for disease that is paid according to number, it must be something more normal of clinic diagnosis standard, the expenses are clearer, common disease that comparatively occured frequently. Not every disease can pay according to number, for example rare disease project pay suitable according to make a diagnosis right away. "
Popularize in an all-round way and still restrict factors
The insider tells reporters, generally speaking, pay the main way of paying that is facing and is in hospital and specialized department medical care according to number. This kind of way of paying, according to diagnosing and dividing various diseases into different groups, then average expense of the scheme make the expenses standard according to make a diagnosis rationally by every the intersection of group and disease. And better paying the mechanism, will consider every disease group hits the severity of disease. It will must carry on statistical analysis to the average expenses of a large number of case histories to design better paying the mechanism according to number, and should adjust regularly according to the level of consumption of the particular area.
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