继上海市率先实行“中小学生和幼儿园儿童住院医疗保险办法”后,全国许多地区也纷纷开设了各种形式的医疗保险业务,从实施情况看,有喜有忧。笔者认为,建立社会医疗保险制度,无疑是医疗卫生改革的一条必由之路,至于暴露出来的一些问题,并非是制度本身缺陷,而是社会因素的制约,不仅医疗保险中存在,公费医疗中也存在;不仅这一险种存在,其他险种上也存在。我们可以通过深化改革,建立“医疗保险担保制度”措施来有效遏制出现的弊端。 Following Shanghai’s lead in implementing the Measures for Resident Medical Insurance for Children in Primary and Secondary Schools and Kindergartens, many forms of medical insurance business have also been set up in many parts of the country. The author believes that the establishment of a social medical insurance system is undoubtedly the only way for medical and health care reform. As for some problems exposed, it is not a flaw of the system itself but a restriction of social factors. Not only medical insurance but also public medical expenses exist; Not only this insurance exists, but also exists in other insurance. We can effectively curb the shortcomings by deepening the reform and establishing the “Medicare guarantee system” measures.