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(一)福建省城镇职工医疗保障制度同其他兄弟省市一样,建立于中华人民共和国成立初期,当时主要包括机关事业单位职工的公费医疗制度和企业职工的劳保医疗制度。除机关事业单位和国有企业职工(县以上大集体职工)外,其余的企业职工和城镇的其他社会成员实行自费医疗,他们如果患病到医院就医所发生的医疗费用全部由患者个人或其家庭负担。在当时的计划经济体制下,公费医疗和劳保医疗制度,在预防疾病、救死扶伤、提高人民健康水平、减轻职工及家庭的经济负担等方面,曾发挥很大作用。但是改革开放后,随着社会主义市场经济体制在我国的逐步建立,公费医疗和劳保医疗制度也暴露出一些令人忧虑和亟待解决的问题。第一,医疗费用增长过快。据统计,1986年至1993年的八年间,享受公费医疗的人群人均医疗费支出,平均每年增长35.84%。公费(劳保)医疗经费支出增长过快,给国家财政和企业带来沉重的经济负担。第二,医疗资源浪费严重。公费(劳保)医疗“个人看病,医生开方,国家财政或企业掏钱”的体制,导致职工费用意识淡薄,追求高医疗消
(1) The medical insurance system for urban workers in Fujian Province, like other fraternal provinces and cities, was established in the early days of the People’s Republic of China. At that time, it mainly included the public medical insurance system for staff and workers of government departments and public institutions and the medical insurance system for workers and staff of enterprises. Except for the organs and public institutions and employees of state-owned enterprises (large collective workers above county level), the rest of the enterprise workers and other members of the society in cities and towns are subject to self-pay medical treatment. All the medical expenses incurred by them to the hospital for medical treatment are paid by the individual patient or his family burden. Under the then planned economy system, the public health and labor protection medical system played a significant role in preventing diseases, saving and reducing lives, improving people’s health and alleviating the financial burden on workers and families. However, after the reform and opening up, with the gradual establishment of the socialist market economic system in our country, the public health and labor protection medical systems have also exposed some worrisome and urgent problems to be solved. First, medical expenses have risen too fast. According to statistics, from 1986 to 1993, the per capita medical expenses for those who enjoy public medical expenses have increased by an average of 35.84% annually. Expenditure on medical expenses (public health insurance) has risen too fast, posing a heavy financial burden on the state treasury and enterprises. Second, serious waste of medical resources. Public (labor insurance) medical “personal medical treatment, the doctor prescribe, the state finance or business pay ” system, resulting in weak awareness of staff costs, the pursuit of high medical care