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二、国际医疗保险的改革
80 年代初有学者提出“医疗卫生体制进化论”, 指出发达国家医疗卫生体制正沿着相似的轨道发展, 即由无组织的个人医疗消费向有组织的医疗服务渐进, 由自费医疗向合型、社会医疗保险型、全民健康保险型、政府医疗保险型、社会主义医疗服务型发展。90年代初, 随着苏联、东欧社会主义国家的解体和我国的经济改革, 传统意义上的计划经济体制发生了巨大的变革。这一理论中发展链条上前半部分看来是成立的; 但是, 最后趋向“社会主义医疗服务型”的判断尚待实践检验。医疗保险模式由低级向高级发展这一趋势是肯定的。
首先，计划型医疗保险引人竞争机制计划型。医疗保险的优势主要在于它引起卫生资源二次分配的公平性。但是, 明显的不足是医疗服务利用效益不高。英国撒切尔政府1991 年实行了三条改革措施, 把市场竞争机制引进了国家保健服务制, 目的是要把计划优势与市场竞争优势结合起来, 把公平与效率结合起来。1993 年, 德国通过“卫生结构改革方案”也把加强保险组织之间的竞争作为提高效益的一项重要改革措施。近年来, 我国医疗单位划小核算单位, 改革用人制度与分配制度等措施, 也向着改进管理, 引入竞争, 提高效益的方向进行了探索。
其次，市场型医疗保险向“管理下的竞争”模式发展。美国是市场型医疗保险的典型。由于医疗费用的急剧上涨, 许多人缺乏必要的医疗保险、获取医疗服务困难, 美国的医疗保险制度引起社会的普遍不满。有四分之三的美国人认为美国的医疗保险制度应彻底改革。1994 年, 克林顿推出“管理下的竞争”改革一揽子方案, 提出要建立全国统一的医疗保险体制, 规定所有企业和雇员都必须参加医疗保险并各自承担一定比例的保险费, 对贫困者继续给予补贴, 保留对老年人和残疾人的医疗福利政策, 把地区和城市医疗机构划分成若干个组合体。方案中至关重要的内容是在各州建立医疗保险管理机构, 对全国的医疗保险实行统一的管理与监控。从管理机构与政策法规上大大加强政府对医疗保险管理, 监控的力度, 仍保留竞争机制的活动。克林顿的改革计划虽未获国会通过, 但也受到相当多的支持, 一个折中的改革方案还会提出。新加坡政府也开始认识到在卫生服务市场中存在的市场失灵现象, 逐步加强对卫生服务领域的干预。
第三，社会医疗保险模式已成为当今世界医疗保险的主流。社会医疗保险诞生在德国。一个多世纪以来, 这种模式的医疗保险一直在稳步发展。至今已有94 个国家实行了社会医疗保险, 其中有一半以上的国家是发展中国家。在不同的发展阶段保险的对象、保障的程度、保障的层次有所不同。例如早期德国对蓝领职工实行强制性保险, 近年来也允许一部分蓝领职工参加非强制性的补充保险; 同样实行社会医疗保险的发展中国家与发达国家在保障程度上有很大的差距, 各个国家的具体做法也不尽相同。例如德国采取的是间接提供医疗服务的做法, 而近年来某些国家采取的是直接提供医疗服务的做法。总的看来, 社会医疗保险模式较好地体现了保障水平与国民经济发展水平相适应的原则; 国家、单位与个人分担医疗费用的原则; 公平与效益相结合的原则; 反映了社会保险强制性、普遍性、保障性、福利性的特征。无论从发达国家还是从发展中国家政策取向上看, 或是从我国和东欧一些国家的改革方向上看, 社会医疗保险将是世界医疗保险制度中的主流。
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Second, the international medical insurance reform
In the early 1980s some scholars have put forward the &theory of evolution health care system& that developed along the health care system is similar to the track of development, that is not organized by the personal consumption of medical services to the organized medical advance at their own expense, from health care to a type, Community-based health insurance, national health insurance-type, the type of medical insurance, medical service-oriented socialist development. In the early 1990s, with the Soviet Union and socialist countries of Eastern Europe and the disintegration of China's economic reform, the traditional sense of the planned economic system has undergone tremendous changes. This theory in the development of the first half of the chain approached appears to be set up, but tend to last a &socialist health care services& of the judgement pending the test of practice. Medical insurance model from low level to high-level development of this trend is positive.
First, the planned medical insurance plan of soliciting the mechanism of competition. The main advantage of medical insurance is that it caused the allocation of health resources secondary equity. However, the apparent lack of effective use of medical services is not high. British Thatcher government in 1991 introduced three reform measures, the market competition mechanism introduced a national health service system, purpose is to plan and market competitive advantage with the fairness and efficiency combined. 1993, Germany adopted the &health programme of structural reforms& to strengthen the competition between insurance organizations improve efficiency as an important reform measures. In recent years, China's medical unit is zoned small accounting units, personnel system reforms and the distribution system and other measures, but also towards the improvement of management, introduce competition and improve efficiency in the direction of the exploration.
Second, market-based health insurance to &managed competition& model development. The United States is the market-based health insurance typical. Because of the steep rise in medical costs, many people lack the necessary medical insurance, access to medical services difficult, the U.S. medical insurance system for the universal cause of social discontent. Three-quarters of Americans think the U.S. medical insurance system should be thoroughly reformed. In 1994, Clinton launched &managed competition& reform package, proposed to establish unified national medical insurance system, requiring all enterprises and employees must participate in medical insurance and their commitment to a certain percentage of the premium, the poor continue to give subsidies , The elderly and people with disabilities to retain the policy of medical benefits, medical institutions and urban areas divided into a number of combinations. Programme is essential to the establishment of the state medical insurance management institutions, the national health insurance implementation of unified management and monitoring. From management institutions and policies and regulations on the Government to greatly enhance the medical insurance management, monitoring, and still retain a competitive mechanism activities. Clinton's reform plan not yet been passed by Congress, but has also been considerable support, a compromise reform package will be made. The Singapore Government also began to realize that in the health services market in the phenomenon of market failure, and gradually strengthening the health services area of intervention.
Third, the social health insurance has become a model in today's world of mainstream medical insurance. Social health insurance was born in Germany. More than one century, this model of health insurance has been a steady development. So far, 94 countries of the social medical insurance, of which more than half of the countries are developing countries. In different stages of development of the insurance object, the degree of protection, the level of protection is different. For example, Germany's blue-collar workers early implementation of mandatory insurance, in recent years also allows part of blue-collar workers participate in non-compulsory sup implementation of the same social health insurance in developing countries and developed countries in the level of protection there is a wide gap between various countries Specific practices vary. Such as Germany takes the indirect approach to provide medical services, and some countries in recent years to provide medical services is a direct approach. Overall, social health insurance model to better reflect the level of protection and national economic development level of the principle of countries and units and individuals to share medical expenses of the principle of fairness and effectiveness of the pr reflect the compulsory social insurance , Universality, security and welfare of the characteristics. Whether from the developed and developing countries from the policy orientation of perspective, or from China and Eastern Europe in the direction of reform in some countries, the social medical insurance will be the world's medical insurance system in the mainstream. 用微信扫描二维码分享至好友和朋友圈分享到：
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为兴趣而生，贴吧更懂你。&或香港中文大学外国语应用语言学研究生电话面试问题 很急啊 马上就面试了
香港中文大学外国语应用语言学研究生电话面试问题 很急啊 马上就面试了
说实话，我接到电话面试都是三年前的事情了，所以不知道还能不能帮到你。感觉电话是免提状态，有两位老师面试，先是让我简短自我介绍一下，然后问了下我选择这个专业的原因，对哪个具体领域比较感兴趣之类的。他们手中应该有我本科时的成绩单等相关文件，所以还就某个科目的成绩等问了几句，比如：某某学科在某次考试成绩不是特别好呀，是怎么回事呀？。。。这样的问题就要随机应变了~~整个面试的时间并不长，十多分钟吧，全程英文（但是我也有同学说是用中文问的，有些奇怪，建议你还是要把英语练好！）~~不要紧张，问什么就答什么啦，老师们都挺好的，不会为难你，就是问一些基本情况而已。祝你成功！
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& &SOGOU - 京ICP证050897号急，我是2013年考研学中文的现在面临选专业不知道要怎么选，现当代文学和教育学哪个更容易考上啊？纠结_百度知道
急，我是2013年考研学中文的现在面临选专业不知道要怎么选，现当代文学和教育学哪个更容易考上啊？纠结
急，我是学中文的现在面临选专业不知道要怎么选，现当代文学和教育学哪个更容易考上啊？纠结……请有经验的人帮忙参考一下，不考虑兴趣这方面，因为我感觉这两门一样，就看哪个更容易考些，我的目的很明确就是能考上就憨骇封较莩记凤席脯芦行，谁能帮我参考一下啊，感激不尽……
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