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医疗保险改革是世界性难题,而医保费用的控制则又是难中之难。目前我国现有的医改模式,不论是“通道式” 中的“三段支付”,“双轨式”中的个人帐户用完后不得进入社会统筹,还是“三金式”中基金由医保经办机构、用人单位、个人三方“齐抓共管”等,本身就有抑制费用支出的制约机制,然而在实际运作过程中,仅靠这些还远远不够,仍需制定一些专门的费用控制办法,为此不少城市都在努力探索。笔者仅就5种主要的费用控制办法的利弊作一粗浅分析。
Medical insurance reform is a worldwide problem, and the control of medical insurance costs is another difficult task. At present, China’s current medical reform model, whether it is “channel” in the “three sections of payment”, “dual-track” in the personal account can not enter the social pooling, or “three gold” funds administered by the Medicare Institutions, employers and individuals “make concerted efforts” have inherent restraining mechanisms for restraining expenditures. However, in actual operation, these measures alone are not enough and some special cost control measures still need to be formulated Many cities are trying hard to explore. I only make a superficial analysis of the pros and cons of the five major cost control measures.