中国社会科学院研究生院和社会科学文献出版社最近共同发布的《医改蓝皮书:中国医药卫生体制改革报告(2014—2015)》指出,新医改政策已经实施五年,目前已经进入深水区。经过五年多的医改实践,我们取得了一些可喜的成绩,如医保的覆盖率达到全国人口的95%以上,医保水平不断提高,民众就医的可及性与便利性得到了实质性的改善,民营医院快速发展等等。但民众一直抱怨的“看病难、看病贵”的问题没有得到实质性的缓解,医患关系没有得到明显的改善等。医改一直是全民热议的话题,也是一个世界性的难题。有研究认为,现阶段评估医改主要为1有效解决看病贵、看病难;2改善医患紧张关系;3真正调动医改主力军的广大医务人员的积极性。这后两个问题的关键涉及到医患沟通和病人参与医护共同决策,是当前全球医学和生物医学伦理及医改研究的热点之一。 The Blue Book on Healthcare Reform: Report on the Reform of China’s Medical and Health System (2014-2015) recently released by the Graduate School of the Chinese Academy of Social Sciences and the Social Sciences Academic Press recently pointed out that the new medical reform policy has been implemented for five years and has now entered the Sham Shui Po area. After more than five years of medical reform practice, we have made some gratifying achievements. For instance, the coverage rate of medical insurance has reached over 95% of the national population, the level of medical insurance has been continuously raised, and the accessibility and convenience of public medical treatment have been substantially improved. Rapid development of private hospitals and so on. However, the public has always complained that the problems of “difficult medical treatment and expensive medical treatment” have not been substantially alleviated and the relationship between doctors and patients has not been significantly improved. Medical reform has always been a popular topic of discussion, but also a worldwide problem. Some studies suggest that the current assessment of health care reform is mainly to effectively solve the expensive medical treatment, difficult to see a doctor; 2 to improve the tension between doctors and patients; 3 the real mobilization of the vast majority of medical reform medical reform staff enthusiasm. The key of these latter two issues involves the communication between doctors and patients and the decision-making of patient participation in health care. It is one of the hot topics in the current global medical and biomedical ethics and medical reform research.