CAJ | 학술논문

在实现全民医保覆盖、基本医疗保险成为医疗服务最大买方的条件下，医保的功能远不止于被动地支付医疗费用，关键的作用在于主动地引导医疗资源配置，促进分级诊疗体系建立。目前我国医保政策以调整支付比例为主要手段，未能发挥引导作用。据此，本文提出了医保如何引导医疗资源配置的政策建议，一方面应建立医保医师制度，提高现有医疗资源的配置效率，另一方面应鼓励私人诊所及新型医疗服务模式发展，促生新的医疗资源。
재실현전민의보복개、기본의료보험성위의료복무최대매방적조건하，의보적공능원불지우피동지지부의료비용，관건적작용재우주동지인도의료자원배치，촉진분급진료체계건립。목전아국의보정책이조정지부비례위주요수단，미능발휘인도작용。거차，본문제출료의보여하인도의료자원배치적정책건의，일방면응건립의보의사제도，제고현유의료자원적배치효솔，령일방면응고려사인진소급신형의료복무모식발전，촉생신적의료자원。
Given the fact that universal medical insurance coverage has achieved and the Basic Medical Insurance System has become the biggest payer of medical services, medical insurance should play an important role in guiding medical resources allocation rather than just a passive payer for medical expenses, and in promoting the establishment of a classified medical care system. However, the current medical insurance policies have mainly focused on adjusting the reimbursement rates, therefore, hindering its guiding role. Based on these findings, several policy suggestions on medical resources allocation are raised in the article, which include establishing a medical insurance contract-physician system to improve the effective allocation of limited existing resources, and supporting the development of private clinics and new model of medical services to promote the emerging of new medical resources.