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在新形势下,医改必须把握好四个重点:一、坚持权利与义务的统一。医疗保险以单位及职工履行缴费义务为前提,不缴费,职工就不能享受待遇。但有的单位投机取巧,采取“头疼医头,脚疼医脚”的办法,算小帐,搞短期行为,当职工患了大病,就主动找社保机构要求参加医疗统筹,慷慨缴费,目的是解决比缴费额度大得多的医疗费问题,待问题解决了,一了百了。对这种变相的“权利义务结合”,必须对单位领导加强教育,提高认识,并通过建立相应的责任约束机制以防患于未然。有的单位已参加了统筹,但确因暂时困难无力承担义务,职工得了大病,社保机构可采取灵活措施,保证患者享受医疗保险权利。
Under the new situation, medical reform must grasp four key points: First, insist on the unification of rights and obligations. Medical insurance is based on the premise that units and employees fulfill their payment obligations. Without payment, employees cannot enjoy treatment. However, some units opportunistically adopted measures such as “giving headaches and treating patients with foot pain” to calculate short accounts and engage in short-term behavior. When workers suffer from serious illness, they actively seek social security agencies to participate in medical co-ordination and generously pay fees in order to solve the problem. The issue of medical expenses that is much larger than the payment limit has been solved and the problem has been solved. To this kind of disguised “combination of rights and obligations”, it is necessary to strengthen the education of the unit leaders, raise awareness, and establish a corresponding mechanism of responsibility and prevention in order to prevent problems. Some units have participated in co-ordination, but due to temporary difficulties, they cannot afford their obligations. Workers have been seriously ill and social security agencies can take flexible measures to ensure that patients enjoy medical insurance rights.