摘要
通过定性逻辑推论和全国常规统计数据模拟测算,研究认为从财政筹资入手求得医改突破是有理论依据的,按照净收入与业务收入之间1:4.03的关系,财政补助净投入增加1元钱,百姓医疗费用负担可下降4.03元。若1991年财政即承担起筹资职责(对卫生投入占财政支出的8%),则19年来只需追加投入10 674.3亿元,即可实现高达21 348.7～43 017.6亿元医疗费用的节省,百姓费用负担由此下降34.2%～68.9%。单年不到2 000亿元的追加投入总量,以及总额预算下齐同GDP的稳定增长机制均提示,追加的财政投入完全是政府可以承受的。因此,从政府筹资职能入手,可一揽子解决百姓看病贵等问题,打破僵局,实现医改突破。当然,从财政筹资入手,总额预算基础上,尚需配以支付方式改革,以针对性解决效率低下、高额医疗费用风险以及医疗机构缺乏主动控费意识等潜在问题。
Based on qualitative analysis and simulation,this paper discovered that the relationship of 1：4.03 between hospitals＇ revenue and operating revenue provided the solid theory basis for breaking through health reform through increasing government subsidies in China.In a word,with the government increasing 1 Yuan subsidies to hospital,operating revenue of hospitals should decrease 4.03 Yuan.For example,if the government undertook the financing function and invested supplementary subsidy in medical services of 1067 billion Yuan since 1991,medical expenditure would have been saved between 2135 and 4302 billion Yuan so far.And so the medical burden of the folks between 34.2%and 68.9%had decreased.Supplementary subsidy of less than 200 billion Yuan in 2010 and its stable growth with GDP under global budget will not exceed the government bearing capabilities at present.In conclusion, it is possible to solve a package of the existing major problems in the folks,hospitals,pharmaceutical market and department of medical insurance and break through health reform in China by increasing government subsidies. Of course,it is indispensable that transforming ＂fee for service＂ into ＂Global budget and Service unit＂ in order to resolve potential problems such as inefficiency,risk of high medical expenditure and lack of awareness of medical expenditure control in hospitals.
出处
《中国卫生资源》
2011年第1期7-9,共3页
Chinese Health Resources
基金
国家自然科学基金重点项目基金资助
项目编号:70733002
"长江学者特聘教授"项目基金资助
教育部2009年度创新团队项目基金资助
项目编号:IRT0912
关键词
总额预算
政府筹资
医疗改革
看病贵
Global budget
Government subsidies
Health reform
＂Seeing a doctor is expensive＂
