守正、发展与创新:“十四五”时期医疗保障的完善思路

人口结构、就业形态、新时代的健康政策与脱贫攻坚任务、技术发展等宏观环境,为“十四五”时期医疗保障的发展提供了机遇也提出了挑战。立足“十一五”到“十三五”医疗保障从无到有、从制度全民覆盖到实践全民覆盖、待遇水平持续提升、各项机制跨越式发展等发展脉络,“十四五”时期医疗保障的发展思路应定位于守正、发展与创新。第一,坚守公平共享与切实保障的发展理念;第二,回应健康需求与不平衡、不充分的医保制度现状,在待遇保障、筹资机制、支付方式、基金监管等方面补短板、强弱项;第三,直面新形势的新挑战,在新业态人员参保、大病保障、医疗保障与公共卫生资金统筹衔接等方面实现创新与突破。目标是在“十四五”时期实现一个全民享有、公平适度、法治规范、高效便捷、协同联动的医疗保障制度。

Maintaining Principle,Progress and Innovation:the Development Ideas of Health Security during the 14th Five-Year Plan Period

The macro-environment such as population structure,employment patterns,health policies,anti-poverty tasks,and technological development will provide opportunities and challenges for the development of health security during the 14th Five-Year Plan period.From the 11th to the 13th Five-Year Plan,the health security was built from scratch.From system universal coverage to practical universal coverage,continuous improvement of treatment levels,and rapid development of various mechanisms,based on those experience,the health security development during the 14th Five-Year Plan period should set its goal on sticking to the principles,making progress and innovation.Firstly,adhere to the development principle of fair sharing and full commitment;and then,respond to health needs and the current status of the unbalanced and inadequate health insurance system,and make up for shortcomings,strengths and weaknesses in terms of treatment protection,financing mechanisms,payment methods,and fund supervision;finally,face up to the new challenges of the new situation,and achieve innovations and breakthroughs in the areas of insurance for new business types of personnel,protection for serious illnesses,and emergency response to emergencies.The goal is to realize a health security system that is universal,fair and moderate,standardized by law,efficient and convenient,and coordinated during the 14th Five-Year Plan period.