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谢伏瞻
    中国社会科学院学部委员,学部主席团主席,研究员,博士生导师。历任中国社会科学院院长、党组书记,国务院发展中心副主... 详情>>
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李培林
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    神木医改“神”在何处

    摘要

    一向籍籍无名的陕西省神木县,2009年因推行“全民免费医疗”制度而名动天下。其间原因,无外乎两点,一是“全民免费医疗”的说法触动了许多人敏感的神经。实际上神木目前推行的并非没有什么前途的“全民免费医疗”制度,而是方向很对的“全民医疗保险”制度。二是大家印象中,陕西是欠发达地区,欠发达地区政府投巨资搞“全民免费医疗”,着实让人兴奋。有人开始就此指点其他地区,“非不能也,是不为也”。慢来,切莫兴奋。虽说地处西北,神木却是富庶之地,其经济规模在全国百强县中排名第44位。所以,世间有神木,却没有神话,神木无非再次证明了一个简单的道理,“全民免费医疗”也罢,“全民医疗保险”也罢,经济发展水平是不可或缺的条件。以神木为标准,“非不能也,是不为也”的说法,最多对全国百强县有反思价值。虽然神木县的基本医疗保障体系的人口覆盖率高达99%,实现了“全民医疗保险”,但就其制度架构而言,同中国其他地方并没有差别。“神木模式”之“神奇”,主要在于大大提高了城乡居民医疗保险的筹资水平和保障水平,就是城乡居民医保报销水平较高,参保者看病治病时自付比重较低。

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    Abstract

    Shenmu county of Shaanxi province,remained nameless early,became well known of the word for implementing the system of “universal free medical treatment” in 2009. In general,there are two reasons:one is that “the universal free medical treatment” touches the sensitive nerve of many people. In fact,the system of “universal free medical treatment” Shenmu carrying out is not such a system without good future but the one with the right direction. The other is that the impression of Shaanxi is less developed,and the government of such a province spends large sum of money in implementing “universal free medical treatment” is really exciting. Someone begins to criticize other regions,“It is not a question of ability but one of readiness”. Wait,do not be excited. Although located in the northwest,Shenmu is a rich county with the size of its economy ranking 44th in the 100 top counties in nationwide. Therefore,there is Shenmu in the world,but there is no myth,Shenmu once again proves a simple truth that either “universal free medical treatment” or “universal health care insurance” requires the indispensable condition of economic development level. By the standard of Shenmu,the statement of “It is not a question of ability but one of readiness” at most has the value of reflections on the top 100 national counties. Although the population coverage rate of the basic medical security system in Shenmu is as high as 99%,realizing the “universal health care insurance”,but its system architecture has no difference from other parts of China. The myth of “Shenmu model” mainly lies in improving the funding level of urban and rural resident medical insurance and security level. To put it bluntly,the urban and rural resident insurance reimbursement level is higher,and the insured person himself pays with a low proportion when seeing a doctor.

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    作者简介
    朱恒鹏:朱恒鹏,中国社会科学院经济研究所研究员。
    顾昕:顾昕,北京大学政府管理学院教授。
    余晖:余晖,中国社会科学院工业经济研究所研究员。
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