日前《健康报》在时评中称:“一旦医保改革滞后,其他改革很难顺利推进……医改必须先改医保。”这段话的内在逻辑链是“假设:医保改革滞后→推理:影响医改→结论 :必须先改医保”。何以见得医保改革滞后?文章拿医保管理体制说事,称职能分散,协调成本高。笔者以为“医改必须先改医保”是个伪命题。首先,不符合事实。“医保改革滞后”是作者的主观假设。众所周知, Recently, “Health News” in the commentary said: “Once the health care reform lags behind, and other reforms is difficult to smooth progress ... ... Medical reform must first change Medicare.” The internal logic of this passage is “Assumption: the health care reform lags behind the reasoning : Affect the medical reform → Conclusion: you must first change Medicare ”. Why medical insurance reform lags behind? Articles take the health care management system, said the decentralized functions, high coordination costs. I think “medical reform must first change Medicare ” is a false proposition. First, it does not fit the facts. “Health care reform lag ” is the author’s subjective assumptions. As we all know,