摘要
"9+2"区域是指泛珠三角区域。我国三大医保主要是指城镇职工基本医疗保险、城镇居民基本医疗保险和新型农村合作医疗。按现行医保制度规定,参保人员异地就医,需先在参保地申请并指定异地就医的医疗机构,医药费用回参保地报销。随着人口流动的加剧,特别是异地工作的农民工,报销十分不便。异地医保就医结算问题不解决,将制约市场经济下的人才流动,进而影响地区经济发展,应尽快推行"异地就医、联网结算"模式。总体思路:整体规划,分步实施,联网结算。整体规划的前提是实现区域内联网结算(一卡通)。推行异地就医结算改革需分3步走:(1)省区间协议确定互相认可的定点医院;(2)委托代理异地就医服务及结算;(3)联网管理,实现"一卡通"。
Nine plus two regions include the area known as the Zhujiang triangle.China’s three major medical health insurance providers refer to staff members,residents and the new Medicare cooperation from the countryside.Under the current health insurance system,the insured persons must apply to the insurance agency which they had joined previously in their local area;at a designated medical institution.If they need medical treatment in different places they must submit their medical expenses account to the insurance agency.With an increasingly floating population,it is very inconvenient for reimbursement of medical expenses,especially to the migrant workers.It will constrain the flow of talent within the market economy if the issue of settling accounts for intercity insured clients is not solved and will thereby affect economic development in the regions.The mode of medical treatment for intercity clients and networking medical account settlement should be carried out as soon as possible.The general idea： overall planning,implementing step-by-step,and networking account settlement.A prerequisite for the overall planning should be based on reaching the final target of regional network account settlement and issuing an all-purpose medical card.There are three steps to reform the practice of medical account settling for insured intercity clients in their regions：（1） the mutual recognition of designated hospitals among the provinces.（2） entrust the deputy of medical services with settling accounts.（3） network management,achieve the goal all-purpose medical card.
出处
《中国卫生经济》
北大核心
2009年第9期56-57,共2页
Chinese Health Economics
关键词
参保
异地
一卡通
insured intercity
settle accounts
all-purpose medical card
