甘孜州医疗保险制度改革面临的难题之一,是州内参保、异地居住人员的就医及其医疗服务管理。由于甘孜州较恶劣的自然环境和气候条件,退休职工绝大多数居住在内地,且居住分散。实施医保后,既要方便他们就医,又要便于社保机构管理,两者很难兼顾。如果直接定点管理,其有利的方面在于便于对定点医疗机构的医疗服务行为和参保人员的就医进行管理。不利的方面在于:一是不利于方便参保人员自主选择医疗机构就医。直接定点不可能对所有符合条件的医疗机构都定 One of the problems facing the reform of the medical insurance system in Ganzi prefecture is the state insured and the medical treatment of medical staff living in different places and their medical service management. Owing to the harsh natural environment and climatic conditions in Ganzi Prefecture, the overwhelming majority of retired workers live in the Mainland and their living is scattered. After the implementation of health insurance, it is necessary to facilitate them to seek medical treatment and to facilitate the management of social insurance agencies. Both of them are difficult to reconcile. If the direct point of management, its favorable aspect is to facilitate the medical services at designated medical institutions and insured staff management. Adverse aspects are: First, not conducive to facilitate the insured to choose their own medical institutions for medical treatment. Direct fixed point can not be eligible for all medical institutions are set