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198 9年洪都拉斯卫生部 (MOH)实施了中央放权下的医疗收费改革政策。并对地方政府下达了有关规章制度 ,管理条例及中央放权的有关改革精神。实践结果取得了一定的成绩。但各地差异很大 ,也产生了一些新的不公平及其它问题。据测算 ,该国平均每例看病需花费为 0 .1 6美元 ,仅为MOH所支出的 2 %,其中6 7%却已花在该项制度的管理费上。该国宝塔型的收费结构、费用水平的差异和免费的实施 ,产生了新的不平等。洪都拉斯的经验表明 ,权力下放医疗收费制不一定就平等。任何好的制度并非从天而降。它需要人们精心设计 ,积极培训 ,推广、实施。要在试点并取得成功的基础上 ,再推广到面上 ,而不能指望一蹴而就 ,轻易完成
In 1989, the Honduran Ministry of Health (MOH) implemented a policy of reform of medical charges under central decentralization. And the local government has issued relevant rules and regulations, management regulations and the spirit of reform in the central authority for decentralization. The practice results have achieved certain results. However, the differences between the regions are very large and some new inequities and other problems have also emerged. According to calculations, the average cost per doctor in the country is US$ 0.16, which is only 2% of the MOH expenditure, of which 67% has been spent on the management fee of the system. The country’s pagoda-type fee structure, differences in cost levels, and free implementation have created new inequalities. Honduras’s experience shows that decentralized medical fees are not necessarily equal. Any good system does not come from heaven. It requires people to design, actively train, promote and implement. It is necessary to build on the success of the pilot and then promote it to the surface, but not to expect it to be completed easily.