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我国自1998年建立城镇基本医疗保险制度,经过多年改革,现已初步解决了医疗保险经费的筹集问题。但随着医疗卫生服务水平和人民生活质量的提高,近年来医疗保险经费出现了过快增长的趋势,过度医疗、过度用药以及人民就医困难等问题始终没有得到根本性解决。随着参加基本医疗保险人数的上涨,医疗保险费用支出的增长不仅高于其收入的增长,而且增长水平远超于同期国内生产总值,存在着家庭负担繁重的危险,这严重威胁着医疗保险体系持续健康的发展。本文在社会医疗保险费用刚性上涨问题严重的现状下,通过具体分析其费用上涨的原因、医疗保险体制现存的问题,进而提出发展全科医生并实行双向转诊制度等建议措施。
Since 1998, China established the urban basic medical insurance system. After years of reform, the financing of medical insurance has been initially solved. However, with the improvement of medical and health services and the quality of people’s life, medical insurance expenditures have witnessed an over-rapid growth in recent years. Problems such as over-medical treatment, over-medication and people’s medical treatment have not been fundamentally solved. With the increase of participation in the basic medical insurance, the growth of medical insurance expenditure is not only higher than its income, but its growth level far exceeds the GDP of the same period, posing the heavy burden of family burden, which seriously threatens the medical insurance System sustained and healthy development. This article analyzes the reasons for the rising costs, the existing problems of the medical insurance system, and puts forward some suggestions on the development of general practitioners and the implementation of two-way referral system under the serious situation of the rigid increase of social medical insurance costs.