近年来,随着改革的不断深入,社会保险事业有了长足的发展。但由于缺乏良性医疗运行机制,制约了整个社会保险事业的发展。一是“病退”失控。“病退潮”来势凶猛,使退休费用急剧上升,大量来之不易的统筹基金白白流失。究其原因,固然有退休金比工资高、有保障;早办退休再谋职业“两头捞”;企业为减轻负担,支持职工办“病退”等诸多外界因素的影响,但笔者认为其主要因素还在于保险机构本身机制的不完善。因为,目前的劳动鉴定形式上由社会保险机构和卫生部门共同完成,但实际操作中,确诊病伤程度完全由卫生部门医务人员单方面决定,而保险机构在这个关键环节上,由于没有建立必要的病伤诊断审查机制,表现出被动、乏力。在“人情网”下,这种毫无监督审查机制的病伤诊断,导致劳动鉴定实际上已是形同虚设,劳动鉴定这个“闸”门关不紧, In recent years, with the continuous deepening of reform, social insurance has made great strides. However, due to the lack of a sound medical operation mechanism, the development of the entire social insurance has been restricted. First, “sick back ” out of control. “Ebb ” fierce ferocious, so that the sharp rise in retirement costs, a large number of hard-won co-ordination fund lost nothing. The reason is that although there are pensions higher than the salary, guaranteed; As early as retirement and then seek employment “two fishing”; enterprises to reduce the burden on workers to support “sick” and many other external factors, but the author It is also believed that the major factor is the imperfect mechanism of insurance institutions themselves. Because the current form of labor appraisal by the social insurance agencies and health departments to complete, but in practice, the diagnosis of the degree of illness and injury is entirely unilaterally decided by the health department medical staff, and insurance agencies in this crucial aspect, because there is no necessary The diagnosis of sickness review mechanism, showing passive and weak. Under the “human network ”, this no supervision and inspection mechanism of the diagnosis of illness, resulting in labor appraisal is actually null and void, labor appraisal this “gate” door is not tight,