深化“三项”基本社会医疗保险制度改革探讨

通过近10年的逐步建设，与中国特色社会主义市场经济体制相适应的“三项”基本社会医疗保险制度，在解决社会矛盾、促进城乡公共卫生事业发展和均等化方面发挥了积极作用，也一定程度体现了全体国民分享经济发展成果机制的初步建立。但目前的“三项”基本社会医疗保险制度仍存在不公平问题、管理体制问题、“碎片化”问题等，医疗服务机构也需深化改革。应开展城乡社会医疗保险一体化的试点工作，将“三项”合并“两项”，并针对特殊嗜好开征相应的税收，现实社会医疗保险筹资和待遇的公平享受；实施“碎片”整理，深化医疗服务机构改革。

On Reform of Three Basic Social Medical Insurance System

After almost ten years construction, three basic social medical insurance system fitting for market economy system of socialism with Chinese characteristics plays an active role in solving economic and social contradiction, boosting urban and rural public health cause development and equalization and so on, meanwhile, to some extent, embodies the initial setup of the mechanism for all Chinese citizens to share economic development results. Currently, however, the three basic social medical insurance system still has the problems in equalization, management system, decentralized supply and so on, and medical service agencies urgently need reform. China should start pilot work for urban and rural integrated social medical insurance, combine three into two, impose related tax according to special demand, let all Chinese fairly enjoy social medical insurance service and treatment, realize management system reform for decentralized service, and deepen the reform of medical service agencies.