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一、关于总体目标体系 杨健敏:中国的医改已推行多年,各界对于需要重新构筑医疗保障的框架体系已有共识,但对其目标体系的看法却是见仁见智。医改已经走到必须对基本的医疗需求作出新的制度安排的时期。为了制度建设的到位,我们首先需要做的就是使总体目标体系明晰和确立起来。现代医疗保障应当是多个制度的结合体。我们当然可以把迄今为止所有存在过的有效的保障方式都熔为一炉。对应于我国城镇从业人员的医疗保障,当然也可以考虑建立多个支拄的制度体系。现在的问题是其中应当具有怎样的结构,也就是说应当有哪些支柱,它们各自的作用及份量如何,与之相对应的各个主体有哪方,各自的责任是什么等等。这里先请原国务院医改办官员介绍一下政府对于职工医疗保障目标体系的基本设想及其设计思路,然后再请大家发表各自的看法。
I. About the overall target system Yang Jianmin: China’s medical reform has been implemented for many years. There are consensuses on the need to rebuild the framework of medical insurance, but the view on its target system is a matter of opinion. Medical reform has come to a time when new institutional arrangements must be made for basic medical needs. For the establishment of the system, the first thing we need to do is to make the overall target system clear and established. Modern medical security should be a combination of multiple systems. We can of course fuse all the effective safeguards that have existed so far. Corresponding to the medical protection of urban employees in China, it is of course possible to consider the establishment of multiple institutional systems. The question now is what kind of structure it should have, that is to say what pillars it should have, their respective roles and weights, which side of each of the corresponding principals, and what their respective responsibilities are. Here, former officials of the State Council’s Medical Reform Office are asked to introduce the government’s basic assumptions and design ideas for the employee medical insurance target system, and then invite everyone to express their opinions.