医疗保险是社会保障体系的重要组成部分,是妥善解决城镇职工基本医疗,防止因病致贫、因病返贫,不断提高医疗保障水平的有效途径。我省全面实施医疗保险制度已近3年时间,改革取得初步成效。但随着改革的深入,参保面的扩大,参保人数的增加,各种问题逐步显现,有些矛盾日趋尖锐,从事医保管理的人员也切身感受了这一世界性管理难题的难度。医疗保险与其它社会保险相比,有许多共同点,但也有其鲜明的特色。医疗保险管理难,难就难在医疗服务的特殊性上,因而医疗服务管理是医疗保险管理的难点所在,也是重点所在。医疗服务管理“难”在何处?1、医学的高度专业性。医学科学是最复杂、最深奥的科学之一。从事这一工作的医务人员都需经过多年的专门 Medical insurance is an important part of the social security system and is an effective way to properly solve the basic medical care for urban workers and workers and prevent them from returning to poverty and returning to poverty because of illness, so as to continuously raise the level of medical insurance. The province has fully implemented the medical insurance system for nearly 3 years, and the reform has achieved initial success. However, with the deepening of reform, the expansion of the social insurance coverage and the increase in the number of people insured, various problems have gradually emerged. Some contradictions have become increasingly acute. The personnel engaged in the administration of medical insurance have also personally experienced the difficulty of this worldwide management problem. Medicare has many things in common with other social insurances, but it also has its own distinctive features. Medical insurance management is difficult, the difficulty is difficult in the particularity of medical services, medical management is the medical insurance management difficulties, but also the key. Medical service management “hard ” where? 1, highly specialized medical. Medical science is one of the most complex and profound sciences. Medical personnel engaged in this work need to go through years of specialized