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    總理怎么看待破除“以藥補醫”的意義?

    2017-10-17 10:00:16

    “我們通過醫改破除了以藥補醫、理順了醫療服務價格,取消了實行60多年的藥品加成政策。今后要進一步鞏固改革成果,切實造福億萬群眾!”李克強總理在10月9日的國務院常務會議上說。

    當天會議聽取公立醫院綜合改革和醫療聯合體建設進展情況匯報,要求通過深化醫改優化資源配置保障人民健康。截至今年9月,全國所有公立醫院已全部取消藥品加成政策,徹底告別了“以藥補醫”。

    “如果說就業是民生之本,醫療則是民生之要。”總理說,“我們要進一步破解醫改這一‘世界性難題’,切實辦好醫療這一群眾最關心的民生大事。”

    看病有保障、治療能報銷,心里才有底氣,消費也才有信心

    有關部門負責人在匯報中列舉了一組數據:截至今年9月,醫院收入的藥占比從2010年新一輪醫改之初的46.3%降至2016年的38.1%,居民個人衛生支出占衛生總費用比重從2008年的40.4%降至2016年的30%以下,65%的二級以上公立醫院開展了按病種付費的醫保支付方式改革,患者就醫負擔持續下降。

    “千萬別小看這些數字!人民群眾只有看病有保障、治療能報銷,心里才有底氣,消費也才有信心。”李克強說。

    截至目前,全國所有公立醫院已全部開展綜合改革,逐步建立了維護公益性、調動積極性、保障可持續的運行新機制。中國建起了全球規模最大、覆蓋13億人的醫療保障網,更是得到世界的廣泛贊譽。

    國際著名醫學雜志《柳葉刀》日前發布1990-2015年醫療可及性及質量指數全球排名,將中國列為進步幅度最大的3個國家之一。世界衛生組織總干事譚德塞直接稱贊:“中國醫療衛生體制改革規模之大、速度之快、質量之高令人贊嘆。”

    這對中華民族子孫后代的意義不可小覷

    李克強說,取消藥品加成、破除以藥補醫,不僅可以直接減輕群眾看病負擔,推動醫療衛生事業健康發展,同時也有助于緩解抗生素濫用等問題。“這對中華民族子孫后代的意義不可小覷。”

    針對取消藥品加成后,一些醫院收入下降問題,李克強明確要求衛生計生委牽頭抓緊制定鞏固破除以藥補醫改革成果的方案,中央財政要給予支持,“絕不能讓人民群眾為此買單”。

    李克強明確指定人力資源和社會保障部牽頭制定方案,擴大公立醫院薪酬制度改革試點,推動建立多勞多得、優績優酬激勵機制,落實公立醫院用人自主權,進一步調動醫務人員積極性。

    “這兩個‘缺口’補上了,破除以藥補醫后的成果就能鞏固下來,醫改才能進一步深化推進。” 總理說。

    用體制機制改革積極推進醫聯體建設

    “要用體制機制改革積極推進醫聯體建設。”李克強總理明確要求。

    截至今年9月,全國近90%的三級醫院已參與醫聯體試點、實現同級醫院檢查檢驗結果互認,80%以上的居民15分鐘內可以就近就醫。總理說,醫聯體不僅直接便利群眾就醫,也有利于醫院拓展病例病源、積累經驗提升醫療水平。

    李克強強調:“醫聯體建設不能僅讓公立醫院‘包’起來,還要積極探索在體制上吸引民營醫院進來,實現醫療衛生事業健康發展。”

    當天會議決定,要完善配套政策,確保今年10月底前所有三級公立醫院參加醫聯體建設,鼓勵民營醫院等社會辦醫療機構及康復、護理等機構參與。制定相應考核辦法,對縱向合作的醫聯體等分工協作模式實行醫保總額付費等多種方式,通過設置不同報銷比例等措施推進分級診療。加強各層級醫療機構藥品目錄銜接,醫務人員在城市醫療集團和縣域醫共體內執業不需辦理執業地點變更和執業機構備案手續。

    李克強指出,推進醫聯體建設過程中,要進一步以“互聯網+醫療”破解難題。加快推廣遠程醫療、預約診療、日間手術等醫療服務模式,推動在醫療機構之間實現就診卡和診療信息共享,深入推進家庭醫生簽約服務,全面推進醫療便民惠民服務。

    “現在我們三級醫院發展很快,水平也比較高。通過遠程醫療等‘互聯網+’手段,不僅可以改革傳統醫療模式,便利群眾就醫,也有利于調動醫務人員積極性,最大限度用好用活優質醫療資源。”總理說。

    “醫改既是重大民生工程,也是重大經濟舉措,必須持續推進!”李克強說。

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