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id="i2i2jyu4k" class="t" id="a1"><a href="/xywy/yxtqs/">医讯同期声</a></span></h1> <div id="i2i2jyu4k" class="pa_0_5_0_10"> <h1 class="Content_title" id="hh"> <span id="a" style="">医?？缡”ㄏ握饷茨?？</span> </h1> <script>/*jQuery('#hh').width(jQuery('#a').width());*/</script> <div id="i2i2jyu4k" class="Remark"> <span>2014年02月15日 15:24 | 作者:吴学安 | 来源：<a target="_blank">人民政协报</a></span> <span id="i2i2jyu4k" class="fr"> <div id="i2i2jyu4k" class="bdsharebuttonbox"><a href="#" class="bds_more" data-cmd="more"></a><a href="#" class="bds_qzone" data-cmd="qzone" title="分享到QQ空间"></a><a href="#" class="bds_tsina" data-cmd="tsina" title="分享到新浪微博"></a><a href="#" class="bds_tqq" data-cmd="tqq" title="分享到腾讯微博"></a><a href="#" class="bds_renren" data-cmd="renren" title="分享到人人网"></a><a href="#" class="bds_weixin" data-cmd="weixin" title="分享到微信"></a></div> <script>window._bd_share_config={"common":{"bdSnsKey":{},"bdText":"","bdMini":"2","bdMiniList":false,"bdPic":"","bdStyle":"0","bdSize":"16"},"share":{}};with(document)0[(getElementsByTagName('head')[0]||body).appendChild(createElement('script')).src='http://bdimg.share.baidu.com/static/api/js/share.js?v=89860593.js?cdnversion='+~(-new Date()/36e5)];</script> </span><span id="i2i2jyu4k" class="fr">分享到：<img src="/images/fx.jpg" /> </span> </div> <div id="i2i2jyu4k" class="text_box"> <p align="center"> <p> 　　近日，一条“9省市试点跨省就医即时报销，跨省就医的患者不用再回参保地报销”的新闻引发不小反响。然而随后新闻报道称，城镇职工基本医疗保险和城镇居民基本医疗保险目前没有在上述9省市内试点跨省就医即时报销的计划，全国性跨省异地就医即时结算暂无制度性安排。(2013年10月22日《新闻晚报》)</p> <p> 　　据国务院医改办最新消息，国家新农合信息平台最近开通运行，并与北京、内蒙古、吉林、江苏、安徽、河南、湖北、湖南、海南9个省级平台互联互通，今后参合农民将通过这一平台实现跨省就医即时报销。目前绝大部分跨省就医的患者只能回参保地报销，不仅要垫钱，而且手续烦琐，还常常因各种原因报销不了，导致众多流动人口有“保”难“报”。从这个意义上来说，9省市参合农民可实现异地就医即时报销，自然是件便民、利民的好事。</p> <p> 　　虽说9省市参合农民有望实现异地就医即时报销，但这与理想中的异地就医报销似乎还有一定距离。一方面，跨省即时报销仅限于9省市之间，超出这9省市，仍然无法异地报销；另一方面，报销的对象仅限于参加新农合的农民，换句话说，占医保主体的城镇职工和城镇居民是无法在9省市之间异地报销，这无疑令人感到遗憾。</p> <p> 　　中国基本医保统筹层次偏低，大多以县市一级为统筹单位，难以实现异地联网结算。如果这些试点省份的医保平台能实现互联互通，等到条件成熟之后，只需将各省级医保信息平台与国家医保信息平台连接，跨省就医即时报销将在技术上完全可行。然而，需要厘清的是，医?？缡”ㄏ晗视惺抵市越梗际踉虿⒎鞘亲钪饕某钢庖蛩?，区域间利益难以统筹才是最不易攻克的难关。一方面，不同地区的医保缴费水平和保障待遇参差不齐，这使得目前的医保制度处于条块分割的格局；另一方面，推进异地就医即时报销改革，本质是对各区域利益进行重新洗牌，这直接关涉人口流入地和流出地之间医?；鸬钠胶?，不可避免会遭遇阻力。</p> <p> 　　有个形象的比喻，参保居民在本地看病，钱是“从左兜到右兜”，而跨省就医则是“把钱放别人兜里”。通常情况下，经济发达地区医保缴费基数高，返还比例也高，异地就医报销会让发达地区感觉自己是在“花钱买亏”，于是便消极对待这一政策。因而，要推进异地就医报销医改措施，一方面要提高医保统筹层次，首先实现省级统筹，再逐步实现全国统一，最终打破医保制度的属地化管理。因为只有统筹管理全国医保基金，才能便于以转移支付等手段来平衡各地区的医保差距。另一方面，跨省就医异地报销的背后也隐藏着医保“多轨制”的不公诉求。公费医疗、城镇职工医保、城镇居民医保、新农合等医保制度何时并轨到统一的医保体系中，仍将是一个长期、循序渐进的过程。</p> <p> 　　数据显示，2012年全国流动人口已达2.36亿，其中跨省流动人口占到了67％。摆在他们面前的一大现实问题就是异地就医能否医保报销。9个省市信息联网的实现，标志着医保一体化的技术障碍已经在努力清除，但是跨省就医即时报销不只要闯技术关。一方面，推进异地就医即时报销改革，本质是对各区域利益进行重新洗牌，这直接关涉人口流入地和流出地之间医?；鸬钠胶猓豢杀苊饣嵩庥鲎枇?；另一方面，跨省报销难在联网，但并不难在联网技术，而是难在政策和决心，最关键的是政府如何解决其中的利益冲突问题。在清除医保信息统筹的路障之后，接下来就是尽快攻克“利益统筹关”的问题了。在这个意义上，打破医保体系条块分割的局面，我们还有很长的路要走。这并不是否定信息联网的意义，而是要求旨在平衡地区利益的统筹改革，要尽快提上议事日程。</p> </div> <p class="Editor">编辑：于玮琳 </p> <div id="i2i2jyu4k" class="Paging"> </div> <p class="Keyword">关键词：医保报销跨省</p> <h1 class="pv_title_2 mt_15"><a href="/index.shtml" target="_blank" class="more mtb_14">更多</a><span id="i2i2jyu4k" class="t" id="a3"><a href="/index.shtml"><img src="/images/xg_t1.jpg" /></a></span></h1> <div id="i2i2jyu4k" class="pa_0_5_0_10"> <ul class="Related_ul bh_150"> <li><a target="_blank" href="/c/2017-06-30/1626625.shtml">叫停刷医?？ń∩硎嵌砸奖ＶЦ对浇缇榔?/a></li> <li><a target="_blank" href="/c/2017-02-17/1348013.shtml">医保支付标准有望一季度确定仿制药将迎一致性评价大考</a></li> <li><a target="_blank" 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