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<script>/*jQuery('#hh').width(jQuery('#a').width());*/</script> <div id="i2i2jyu4k" class="Remark"> <span>2017年02月23日 08:37 | 来源：<a target="_blank">健康报</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 style="text-indent: 2em; text-align: left;">2月20日，财政部、人社部和国家卫生计生委联合发布《关于加强基本医疗保险基金预算管理发挥医疗保险基金控费作用的意见》，合力推进医保支付方式改革全面实施。（2月22日《21世纪经济报道》）</p><p style="text-indent: 2em; text-align: left;">现实中，由于医疗服务自身的专业属性，公众无论在专业性还是在买方的议价能力上，其实都不足以构成对等的买方市场，由此而形成的药价和医疗费，偏高恐怕在所难免。相比行政指令式的各种限价，真正意义上对药品与医疗服务的合理定价，有赖于买方的议价能力。医保作为药品与医疗服务大宗采购与支付方，本该扮演好集合买家的角色，成为制衡与约束医药价格的议价者。医?；鹂胤鸦频某鎏?，有望促进这一买方角色的归位。</p><p style="text-indent: 2em; text-align: left;">医保支付标准的确定，即便代言的是买方利益，也同样需要考虑卖方的接受程度，这个议价与平衡的过程，并不是简单拍个板那么轻松。而医保控费机制的核心，说白了是按疾病诊断分类设定支付标准，通过统一的疾病诊断分类与定额支付标准，来驱动医疗服务的供给方控制并降低成本。这一机制当然有其合理性与议价效果，而无论是固定服务价格，还是同类诊疗服务取各医院的平均值，都将意味着那些管理低效、成本控制不能达到平均费率的医疗机构、将陷入亏本。医?？胤鸦频娜范ǎ娜酚兄谝搅瓶胤延虢党杀?，以达到适应患者需求与卫生资源消耗双向平衡的目标。</p><p style="text-indent: 2em; text-align: left;">不过，医保支付标准同样也有其局限性。这首先来自医疗服务的复杂性，可能导致医保支付的不合理。面临控费压力，医疗机构不得不压缩限制成本，极有可能不利于那些需要超额资源投入的重症患者。医?？胤驯曜荚窖细竦牡厍饫嘞窒蠛臀侍庠矫飨院推毡??？杉?，医?？胤鸦频娜范?，需要添加合理的调整变量，以更多关照让患者的个体特殊性与医疗资源的灵活对接。医保控费机制要走得更远，需有灵活的议价方式，以避免医?？胤压诮┗案盒в?，而这也是对医保控费能力与智慧的考验。（武洁）</p> </div> <p class="Editor">编辑：赵彦 </p> <div id="i2i2jyu4k" class="Paging"> </div> <p class="Keyword">关键词：医?？胤?#32;灵活议价医保支付标准</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 class="Related_ul bh_150"> <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" href="/c/2017-02-17/1347208.shtml">医保支付标准一季度有望确定</a></li> <li><a target="_blank" href="/c/2017-02-17/1347211.shtml">医保支付标准一季度有望确定</a></li> <li><a target="_blank" href="/c/2019-02-01/2277443.shtml">国家医保局通报八起骗医保案例相关法律亟需完善</a></li> <li><a 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