基本药物医保报销政策研究  

The Study on Health Insurance Reimbursement Policy of Essential Medicine

作　　者：夏俊[1] 田昕[2] 张新平[2] 

机构地区：[1]华中科技大学同济医学院附属同济医院,武汉430030 [2]华中科技大学同济医学院,武汉430030

出　　处：《医学与社会》2010年第6期64-66,共3页Medicine and Society

摘　　要：基本药物制度落实与医保配套政策紧密相关。本文提出了基本药物报销政策不明确,不同地区、不同险种报销政策差距较大两个主要问题。分析问题产生原因,是由于政府财政投入不确定,全国各地区经济水平差异较大,各险种筹资水平差距较大三个主要原因造成的。提出了基本药物医保报销政策:不设起付线、报销比例80%以上、设置封顶线。并给出了实现报销政策设计的主要三种途径,即:增加政府财政投入,减小各种医疗保险体系筹资水平差距,减少保险基金结余。The implement of essential medicine system is closely related to supporting policies of medical insurance system.This paper putting forward two major problems,uncertainty of reimbursement policies of essential medicine system and large gap among reimbursement policies of different types of insurance.Analyzing the causes of the problems,they are caused by three main reasons,including uncertainty of the government financial input,differences among the economic level in different regions all over the country,large gap among the financing levels of different types of insurance.Finally,we proposed the medicare reimbursement policy of essential drugs：set no doorsill line,reimbursement proportion more than 80%,set top line.We put forward the three major ways to realize the design of the reimbursement policies：increase government financial input,narrow the gap among the financing levels of different types of medical insurance system,reduce the insurance fund surplus.

关 键 词：基本药物 医保 报销 

分 类 号：R197.1[医药卫生—卫生事业管理]