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2009年启动的新一轮医疗改革,明确医改的目的是维护人民健康权益,要建立覆盖城乡居民的基本医疗卫生制度。十八大文件也明确了这一精神。本轮医改已实现了基本医保全覆盖,基层公共卫生体系建设有很大发展。但是,公立医院沿袭多年的创收机制导致的看病贵和医患矛盾,以及药品供应和药价等问题并未好转。多年形成的利益格局已成为医改的阻力。医疗服务业的特殊性,决定了医疗的公益性目标不可能由市场化实现,政府应当承担责任。在继续改革深化中,要坚持2009年以来医改的基本原则和总体布局,纠正片面强调“社会办医”的倾向,把公立医院回归公益性改革作为推进整体医改的核心,注重改革的系统性和协同性。
The new round of health care reform launched in 2009 clarified that the purpose of medical reform is to safeguard people’s health rights and interests and establish a basic medical and health system that covers urban and rural residents. Eighteen documents also clear this spirit. The current round of medical reform has achieved a complete coverage of basic medical insurance and a great development has been made in the construction of grassroots public health systems. However, the long-term revenue-generating mechanism in public hospitals has led to the high cost of seeking medical care and the contradiction between doctors and patients, and the problem of drug supply and drug prices has not improved. The pattern of interests formed over many years has become a resistance to medical reform. The particularity of the medical service industry determines that the goal of medical public welfare can not be achieved through marketization, and the government should assume the responsibility. In deepening the reform, we must adhere to the basic principles and overall layout of medical reform since 2009, correct the one-sided emphasis on the “social practice of medical treatment,” and return the public hospital to public welfare reform as the core of the overall medical reform and pay attention to the system of reform Sexuality and synergy.