近年,医保支付制度改革是各地医保工作的重心,但总体而言,大多是为了改革而改革,出台的管理办法也更多基于管理者自身需求的考虑,而极少去研究支付制度改革过程中“相关利益者”的问题,以致有些地方出现了医、保之间为总额分配问题对簿公堂,医院以总额不够为由故意推诿重病号等问题。本 In recent years, the medical insurance payment system reform is the focus of medical insurance throughout the country, but overall, most of them are for reform and reform. The management measures introduced are also more based on the managers’ own needs, and seldom study the reform of the payment system “Relevant stakeholders ” issue, so that in some places there has been a problem of total distribution between doctors and nurses in the court of justice, and the hospital deliberately prescribes serious illness on the ground of insufficient amount. this