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class="bw_750 fl"> <h1 class="pv_title_2"><span id="i2i2jyu4k" class="site fr"><a href='/'>首页</a>><a href='/xywy/'>寻医·问药</a>><a href='/xywy/wyjt/'>委员讲堂</a></span><span id="i2i2jyu4k" class="t" id="a1"><a href="/xywy/wyjt/">委员讲堂</a></span></h1> <div id="i2i2jyu4k" class="pa_0_5_0_10"> <h1 class="Content_title" id="hh"> <span id="a" style="">孙丰源委员：异地医保跨省结算需统一标准</span> </h1> <script>/*jQuery('#hh').width(jQuery('#a').width());*/</script> <div id="i2i2jyu4k" class="Remark"> <span>2016年03月01日 09:25 | 来源：<a target="_blank">新京报</a></span> <span id="i2i2jyu4k" class="fr"> <div id="i2i2jyu4k" class="jiathis_style_24x24"> <a class="jiathis_button_qzone"></a> <a class="jiathis_button_tsina"></a> <a class="jiathis_button_tqq"></a> <a class="jiathis_button_weixin"></a> <a class="jiathis_button_renren"></a> <a class="jiathis jiathis_txt jtico jtico_jiathis" target="_blank"></a> </div> <script type="text/javascript" src="http://v3.jiathis.com/code_mini/jia.js?uid=1399539302485450" charset="utf-8"></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"> <div style="padding: 10px; margin: 0px; border: 0px; -webkit-tap-highlight-color: rgba(0, 0, 0, 0); font-size: 16px; line-height: 32px; white-space: normal; text-indent: 2em; text-align: left; background-color: rgb(255, 255, 255);"><p style="text-align:center"><img id="{2BEF9436-8929-4457-93FF-11280539D347}" alt="" src="/upload/resources/image/2016/03/01/196576_600x600.jpg" style="padding: 0px; margin: 0px; border-width: initial; -webkit-tap-highlight-color: rgba(0, 0, 0, 0);"/></p><p style="text-indent: 2em; text-align: left; font-size: 14px;">全国政协委员孙丰源认为，实现异地医保跨省结算，最重要的就是全国统一标准。受访者供图</p><p style="text-indent: 2em; text-align: left; font-size: 14px;">推动医?？缡〗崴闶橇交岽砦惫惴汗刈⒌幕疤狻Ｈツ?，多位代表、委员都提出了相关议案、提案。</p><p style="text-indent: 2em; text-align: left; font-size: 14px;">政协委员孙丰源提出，实现医保联网结算，解决异地报销问题。这个问题也写进了2015年总理的政府工作报告。报告提出，基本实现居民医疗费用省内直接结算，稳步推行退休人员医疗费用跨省直接结算。</p><p style="text-indent: 2em; text-align: left; font-size: 14px;">一年过去了，我国基本上实现了省内医保异地结算。中南地区、京津冀地区、东北地区还开始探索建立区域间的跨省结算政策。</p><p style="text-indent: 2em; text-align: left; font-size: 14px;">对于异地医保跨省结算，孙丰源认为，国家应该统一医保标准，通过几个省之间的区域跨省结算，实现全国跨省结算。他也建议，加快户籍改革的力度，对持居住证的外来人口给予同等的医保待遇，进而解决“异地”问题。</p><p style="text-indent: 2em; text-align: left; font-size: 14px;"><strong style="padding: 0px; margin: 0px; border: 0px; -webkit-tap-highlight-color: rgba(0, 0, 0, 0);">★对话人物</strong></p><p style="text-indent: 2em; text-align: left; font-size: 14px;"><strong style="padding: 0px; margin: 0px; border: 0px; -webkit-tap-highlight-color: rgba(0, 0, 0, 0);">孙丰源</strong></p><p style="text-indent: 2em; text-align: left; font-size: 14px;">全国政协委员、天津医科大学眼科医院副院长，去年两会期间提出，实现医保联网结算，解决异地报销问题。</p><p style="text-indent: 2em; text-align: left; font-size: 14px;">医?？缡〗崴惚砻婵词且桓黾际跷侍?，就是医保联网的问题，实际上是结算病种、价格、报销比例、医保支付标准的问题。这些东西不统一，就无法实现跨省结算。</p><p style="text-indent: 2em; text-align: left; font-size: 14px;"><strong style="padding: 0px; margin: 0px; border: 0px; -webkit-tap-highlight-color: rgba(0, 0, 0, 0);">探路</strong></p><p style="text-indent: 2em; text-align: left; font-size: 14px;"><strong style="padding: 0px; margin: 0px; border: 0px; -webkit-tap-highlight-color: rgba(0, 0, 0, 0);">实现几省之间异地医保结算</strong></p><p style="text-indent: 2em; text-align: left; font-size: 14px;">新京报：异地医保结算是包括你在内的代表、委员一直关心和推动的政策。这项政策能影响到哪些群体？</p><p style="text-indent: 2em; text-align: left; font-size: 14px;">孙丰源：影响的群体很多，包括进城务工人员、异地安置的退休人员，投亲靠友在户籍地外常住的人。还有一方面是病人流动，大多数是疑难杂症或重大疾病转诊的。</p><p style="text-indent: 2em; text-align: left; font-size: 14px;">新京报：目前，全国基本上实现的省内异地结算，效果如何？</p><p style="text-indent: 2em; text-align: left; font-size: 14px;">孙丰源：因为经济发展的差距，我国医疗资源存在着分布不均的情况。但目前来说，每个省基本都有相对好的龙头医院。实现省内异地医保结算，老百姓在他那个省好一点的医院看病，就能直接报销结算。</p><p style="text-indent: 2em; text-align: left; font-size: 14px;">新京报：去年，我国部分区域出台了几个省之间的异地医保结算政策。</p><p style="text-indent: 2em; text-align: left; font-size: 14px;">孙丰源：去年两会我提出，应考虑区域性试点模式，将医疗资源、社会经济水平较为接近的几个省市或地区划为可联网结算的大区域。</p><p style="text-indent: 2em; text-align: left; font-size: 14px;">像华东、华中等地区，发展差距不大，也包括京津冀地区要实现协同发展。这种情况下，某几个省之间就有条件实现统一的医保结算。</p><p style="text-indent: 2em; text-align: left; font-size: 14px;">新京报：这是否意味着短期内，我们就能实现全国统一的异地医保跨省结算？</p><p style="text-indent: 2em; text-align: left; font-size: 14px;">孙丰源：实现全国范围内的跨省结算，需要全国有统一的医保标准，这需要政策的制定者下决心。不过，实现省内、几个省之间的异地医保结算，也可以积累一些经验。</p><p style="text-indent: 2em; text-align: left; font-size: 14px;"><strong style="padding: 0px; margin: 0px; border: 0px; -webkit-tap-highlight-color: rgba(0, 0, 0, 0);">现状</strong></p><p style="text-indent: 2em; text-align: left; font-size: 14px;"><strong style="padding: 0px; margin: 0px; border: 0px; -webkit-tap-highlight-color: rgba(0, 0, 0, 0);">病还没看，先为医保奔千里</strong></p><p style="text-indent: 2em; text-align: left; font-size: 14px;">新京报：你是眼科医生，是什么让你关注到异地医保结算的问题？</p><p style="text-indent: 2em; text-align: left; font-size: 14px;">孙丰源：工作中，我很少看本市的普通眼科，我的病人都是从外地来的，这些病人几乎都面对医保报销、结算的问题。</p><p style="text-indent: 2em; text-align: left; font-size: 14px;">我以前在医院分管医保工作，对这方面了解比较多。不能实现医保异地结算，患者不但要先垫付医疗费，在医保报销程序上也很费周折。</p><p style="text-indent: 2em; text-align: left; font-size: 14px;">新京报：这给病患的生活带来哪些实际的影响？</p><p style="text-indent: 2em; text-align: left; font-size: 14px;">孙丰源：许多农村来的病人，一住院往往医疗费成千上万。没有钱，又不能直接在我们医院刷卡，就得先垫上。一些病人治一场病，生活就成问题了。等他治完病回去，有的要经过乡镇、县，再到地区一级，才能报销，拿到钱又得经过一段时间，给他们造成了不小的经济负担。</p><p style="text-indent: 2em; text-align: left; font-size: 14px;">还有时间上、交通上的成本。有的病人不是治好了回去走报销程序，而是在看病期间就要回家办医保手续。</p><p style="text-indent: 2em; text-align: left; font-size: 14px;">新京报：有让你印象深刻的事例吗？</p><p style="text-indent: 2em; text-align: left; font-size: 14px;">孙丰源：就在上周四（2月25日），我在门诊给一个从贵州来的病人看病。他患的是眼眶肿瘤，我告诉他需要住院治疗。但他跟我说，得先回去办医保转诊手续。我问他，“怎么不在家办好了转诊手续再来我们医院看呢？”他说：“万一你这里治不了，或者不给我治，我还得到别的城市，那转诊还得重办。所以得先来一趟看看?！?/p><p style="text-indent: 2em; text-align: left; font-size: 14px;">病还没治呢，就得先大老远地折腾。</p><p style="text-indent: 2em; text-align: left; font-size: 14px;">新京报：除了经济和时间上的成本，不能实现异地医保结算还带来哪些问题？</p><p style="text-indent: 2em; text-align: left; font-size: 14px;">孙丰源：一个社会公平的问题。我们国家现在基本实现了医保全覆盖，但为什么地区之间支付的标准不一样？比如你花100块钱，在天津可以报70，回到家乡就只能报50了。这影响了我们医疗保险的公平性。</p><p style="text-indent: 2em; text-align: left; font-size: 14px;">这个民生问题对民众影响很大，也很迫切。在这方面，政府应该下决心，让它一致起来。</p><p style="text-indent: 2em; text-align: left; font-size: 14px;"><strong style="padding: 0px; margin: 0px; border: 0px; -webkit-tap-highlight-color: rgba(0, 0, 0, 0);">分析</strong></p><p style="text-indent: 2em; text-align: left; font-size: 14px;"><strong style="padding: 0px; margin: 0px; border: 0px; -webkit-tap-highlight-color: rgba(0, 0, 0, 0);">“实行单病种付费，进而统一医保标准”</strong></p><p style="text-indent: 2em; text-align: left; font-size: 14px;">新京报：你认为解决异地医?？缡〗崴愕睦言谀睦铮?/p><p style="text-indent: 2em; text-align: left; font-size: 14px;">孙丰源：地区间发展不平衡。各地在医?；鸬氖罩胶馍洗嬖诤艽蟛钜臁＞梅⒄购玫?、交医保多的省市，医?；鹁统渥悖ㄏ谋曜季筒灰谎?。除了要解决发展的问题，还要在全国层面协调统筹。</p><p style="text-indent: 2em; text-align: left; font-size: 14px;">还有医保报销目录、用药目录上的问题。同样一个病，我给病人开了这种药，在我们这可以走医保报销，到了他的户籍地就不能报。所以医保目录也要尽快实现全国统一。</p><p style="text-indent: 2em; text-align: left; font-size: 14px;">新京报：对此你有什么解决的建议吗？</p><p style="text-indent: 2em; text-align: left; font-size: 14px;">孙丰源：我们现在实行的单病种付费，就是通过统一的疾病诊断分类，制定出每种疾病的定额偿付标准，医?；拱凑飧鐾骋槐曜枷蛞搅苹怪Ц斗延谩?/p><p style="text-indent: 2em; text-align: left; font-size: 14px;">比如白内障，根据合情合理的医疗资源消耗，制定出它总共需要花多少钱来治。单病种付费的项目越多，规划就越强，进而推动全国的医保标准实现统一。用制度来约束医疗行为。这对推动统一医保标准有很大意义。</p><p style="text-indent: 2em; text-align: left; font-size: 14px;">新京报：人社部提出，让60%左右的群体异地就医能在同一城市内实现，30%左右群体在一个省内不同城市之间可以实行结算。如何实现90%的人能在省内看?。?/p><p style="text-indent: 2em; text-align: left; font-size: 14px;">孙丰源：实现分级诊疗转诊制度，把病人留在基层治疗。这是对的。应该让医生来选病人，而不是病人来选医生。很多病人想着要到大城市、大医院去看，当然也是他们出于对身体的担心，但病人不知道哪家医院能看好他的病啊。</p><p style="text-indent: 2em; text-align: left; font-size: 14px;">新京报：把病人留在基层治疗，需要解决哪些问题？</p><p style="text-indent: 2em; text-align: left; font-size: 14px;">孙丰源：需要解决两个问题，一是基层要有药，二是要有能治病的医生。现在我们越是基层，报销的比例越大，引导病人在社区就医。但是很多药，社区的卫生机构都没有，迫使病人往上流动。</p><p style="text-indent: 2em; text-align: left; font-size: 14px;">现在好的医生都愿意到大医院工作，我们要想怎么样能把人才留下来。如果基层的硬件设施、药品种类都齐备了，老百姓也不会花着机票钱、火车票钱到外地去看病。</p><p style="text-indent: 2em; text-align: left; font-size: 14px;"><strong style="padding: 0px; margin: 0px; border: 0px; -webkit-tap-highlight-color: rgba(0, 0, 0, 0);">建言</strong></p><p style="text-indent: 2em; text-align: left; font-size: 14px;"><strong style="padding: 0px; margin: 0px; border: 0px; -webkit-tap-highlight-color: rgba(0, 0, 0, 0);">“持居住证应能享受户籍人口医保待遇”</strong></p><p style="text-indent: 2em; text-align: left; font-size: 14px;">新京报：是不是说实现了分级诊疗和转诊制度，就能消除异地医保结算的问题了？</p><p style="text-indent: 2em; text-align: left; font-size: 14px;">孙丰源：除了到大城市看病的人之外，还有大量的进城务工人员和常居在城市里的非户籍人口。现在，除了急诊外，大部分不能实现异地医保结算。</p><p style="text-indent: 2em; text-align: left; font-size: 14px;">国务院发文提出，要把城镇居民医保和农村新农合统一成一个城乡医保，这对于实现跨省医保结算有推动作用。</p><p style="text-indent: 2em; text-align: left; font-size: 14px;">新京报：解决这些常居在户籍地外的人看病的问题，你还有哪些建议？</p><p style="text-indent: 2em; text-align: left; font-size: 14px;">孙丰源：中央提出推行居住证制度，这是一个好的切入口。除了统一医保标准，实现跨省医保结算外。如果持居住证的居民能够享受户籍人口的待遇，这就不存在“异地”的问题了。</p><p style="text-indent: 2em; text-align: left; font-size: 14px;">所以，“异地”问题，实际上涉及户籍制度的问题。我也希望政府能够尽快出台政策，加快户籍制度改革的步伐。至少在我看来，在医保方面，应该先推动有居住证的外来人口享受和户籍人口同样的医保待遇。</p><p style="text-indent: 2em; text-align: left; font-size: 14px;">本版采写/新京报记者吴为</p></div><p><br style="text-indent: 2em; text-align: left;"/></p> </div> <p class="Editor">编辑：赵彦 </p> <div id="i2i2jyu4k" class="Paging"> </div> <p class="Keyword">关键词：全国政协委员异地医保跨省结算统一标准</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 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class="img" /><ins>姚爱兴</ins></a> <a title="贾宝兰" target="_blank"> <img src="/upload/resources/image/2014/02/10/174.jpg" class="img" /><ins>贾宝兰</ins></a> <a title="谢卫" target="_blank"> <img src="/upload/resources/image/2014/02/10/170.jpg" class="img" /><ins>谢卫</ins></a> <a title="汤素兰" target="_blank"> <img src="/upload/resources/image/2014/02/10/176.jpg" class="img" /><ins>汤素兰</ins></a> </div> </div> </li> </ul> <ul style="display:none"> <li> <div class="i2i2jyu4k" id="sliderbox4" class="sliderbox_box"> <div id="i2i2jyu4k" class="sliderbox" style="opacity:0; z-index:0;"> <a title="黄信阳" target="_blank"> <img src="/upload/resources/image/2014/02/15/1079.jpg" class="img" /><ins>黄信阳</ins></a> <a title="张其成" target="_blank"> <img src="/upload/resources/image/2014/02/15/1003.jpg" class="img" /><ins>张其成</ins></a> <a title="潘鲁生" target="_blank"> <img src="/upload/resources/image/2014/02/15/912.jpg" class="img" /><ins>潘鲁生</ins></a> <a title="冯丹藜" target="_blank"> <img 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