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有必要查艾滋病吗？
2010-01-26 07:45:00 来源: 华龙网-重庆晨报(重庆)
本报讯（记者罗强）“一个81岁的老太太，到医院做个白内障手术，医院却要求检查艾滋病，是不是一定要检查？”昨日上午，市三届人大代表曾照芳、彭应吉、马佳、王嘉玲、许平、夏晋、肖陵、舒静秋等，结合调研情况，就医疗保障与医疗卫生等方面存在的大处方、豪华检查等问题提出了询问案。
另外，这些代表还对医保资金的来源，现在的收支经营状况如何等情况进行了询问。代表们还要求市卫生局在2月底前向人大代表作出书面报告。
质问一》》
眼科手术要查艾滋？
在昨天的询问中，曾照芳代表说，“有一个81岁的老太太，到医院做白内障手术，结果医生要求必须做艾滋病检查，这是什么规定？这样的检查到底有没有必要？”询问现场进入了第一波的紧张状态。
“艾滋病不是每个病人都要检查，但手术病人需要检查，因为手术中可能有供血的情况。”市卫生局副局长周英杰回答。
“你做过医生，我也是。白内障手术需要供血吗？”曾照芳追问。
“这是卫生部的要求，如果检查出有艾滋病，医生的手术过程就会不一样，这是为了保护医患双方，若术后查出了艾滋病，这个责任谁来负。”周英杰的回答立刻引发了紧张气氛。
“主管部门首先想到的是医院责任的规避，怎么没有想到患者的负担？”彭应吉代表质问。
质问二》》
检查结果不能互认？
彭应吉代表接着问：“大医院的医生，一天要接诊100多个病人，这样的接诊，怎样保证得了医疗质量？”
市卫生局医政处一负责人回答说，“这是我们目前分级医疗做得不好。”
“有一次去一家大医院看病，医生从接诊到开处方，前后不足两分钟，开了700多元的药，还让做这样或那样的检查，又是一大笔费用，我们的检查项目太多了，检查费太贵。”彭应吉说，这种现象造成的结果就是，病人有钱买棺材，无钱买药。“有的病，其实完全是可以到社区医院看，但就是因为社区医院缺少设备，群众不信任。我们为什么不考虑将修建三甲医院的钱，投入到社区医院去。”
市卫生局医政处一负责人说：“一般的检查，在社区医院能进行。”
“为什么在一个医院做的检查，到了另一家医院又要重新做，检查结果可不可在医院间互认？”彭应吉追问。
市卫生局医政处一负责人说，“检查结果直接涉及对病情的诊断，误诊、漏诊的责任又很大。现在二级以上的同级医院，有些检测结果可以互认。”
质问三》》
医保支付能否拓宽？
在昨天的询问案中，彭应吉代表还向市人保局问起了医保资金的来源、目前的收支状况等。
“目前，医保资金使用，实行的是自收自支，以收定支，略有节余的原则。”市人保局副局长周平说，现在，从节余上看，医保个人账户的节余额约有26亿元。
“既然有这么多的节余，为什么不扩大医保个人账户的资金的使用面？”彭应吉接着问。
市人力社保局医保处处长蔡岩说，“个人账户的钱，是参保人个人的私有财产，这个节余我们是动不了的，真正能供使用的基金节余很有限，对于个人账户的支付面，我们正在研究，今后将逐步扩大。”
质问四》》
报销门槛能否累计？
“同一个病人，同一种病，在门诊看了没看好，紧接着又去住院，医保报销门槛怎么算？这个病人在门诊看病时，就已经按门诊报销门槛计算了报销费用，住院后的报销门槛可不可以不‘重复计算’？”曾照芳代表问。
彭应吉也提出疑问：“群众也很聪明，干脆来个什么大病小病都去住院，本来是肝有问题，结果他啥子都查，反正只要医疗费超过了门槛费，就可以按比例报销，自己负担的钱就少了，这样一来，各大医院经常是人满为患，住院床位非常紧张。”
蔡岩回答，“按规定，门槛费是按上年度社平工资10%设定，现在我们执行的是2000年的标准，应该说，这已经降低了门槛费了，至于同一病种、相近时间的门诊费和住院费门槛费征收，会有一定幅度的降低。”
The need to check AIDS?
2010-01-26 07:45:00 Source: DragonSoft - Chongqing Morning News (Chongqing)
(Reporter Luo Qiang), "a 81-year-old woman to the hospital to be a cataract surgery, the hospital has asked to inspect AIDS, is not necessarily to check?" Yesterday morning, the city has three deputies according to Fang, Peng Ying Ji, Ma Jia , Wang Jialing, Ping Xu, Xia Jin, Xiao Ling, SHU Jing Qiu, etc., combined with case studies on the health insurance and health care in areas such as large prescriptions, luxury checks had inquired about the case in question.
In addition, these representatives of the health-care funding sources, the current state of business and so on the balance of payments was questioned. Delegates also called for City Health Bureau before the end of February to make a written report to the deputies.
Asked one ""
Eye surgery to check the HIV?
In yesterday's interviews, ZENG Zhao-fang, said, "There is a 81-year-old woman to the hospital for cataract surgery, the results of a doctor to do AIDS test, what kind of requirements? Such inspections in the end there is no need?" Asked the site into the first wave of tension.
"AIDS is not for every patient to check, but the surgical patients need to check because the surgery may have blood of the situation." Municipal Health Bureau deputy director Ying-Jie Zhou replied.
"You did a doctor, I am also. Cataract surgery need blood supply to it?" Zeng Zhao-Fang asked.
"This is the Ministry of Health requirements, if you check out there is AIDS, the doctor's surgical procedure would have been different, it is to protect both doctors and patients, if patients identified with AIDS, who will bear this responsibility." Ying-Jie Zhou answer immediately sparked tensions.
"Competent authorities first thought was to avoid responsibility for the hospital, how the burden of patients did not expect?" Peng Ying-chi representative questioned.
Asked 2 ""
The mutual recognition of test results can not be?
Peng Ying-Ji representative then asked: "great doctors, more than 100 patients a day admissions, such admissions, how to ensure that medical quality won?"
Municipal Health Bureau Yizheng Chu a responsible person replied, "That is what we are doing a good job hierarchy of health care."
"One time go to a major hospital, a doctor from the admissions to the prescription, before and after less than two minutes, to open over 700 diverse drugs, also allowed to do this or that examination, but also a large amount of costs, we examine the project is too more, examination fees are too expensive. "Peng Ying-chi, a result of this phenomenon is that the patient coffin money, no money to buy medicine. "Some patients, in fact, all these can be to look at community hospitals, community hospitals, but because the lack of equipment, people do not trust. Why should we not consider the construction of the top three hospitals in the money into the community hospital."
Municipal Health Bureau Yizheng Chu a person in charge said: "The general inspection can be carried out in the community hospital."
"Why a hospital examination to another hospital, again, do, check the results can not be mutual recognition between the hospital?" Peng Ying Ji asked.
Municipal Health Bureau Yizheng Chu a responsible person, "said test results directly related to the disease diagnosis, misdiagnosis, missed diagnosis has a great responsibility. Now more than two peer hospitals, and some test results can be mutual recognition."
Asked 3 ""
Can expand Medicare to pay?
In the case of yesterday's inquiry, Peng Ying-ji representatives also asked about the City People's Insurance Corporation of health insurance funding sources, the current balance of payments conditions.
"At present, the use of Medicare funds and implement the self-supporting, to close will support a slight savings principle." City, Zhou Ping, Deputy Secretary for Security said that now, from the savings point of view, health insurance section of the balance of individual accounts of about 2.6 billion.
"Since there are so many savings, why not expand the health insurance funds individual accounts using the face?" Peng Ying-chi asked.
City Director of Human IESS health insurance Cai Yan said, "Personal accounts of the money is insured personal private property, the savings that we can not move, and really for the very limited use of the fund balance for the payment of individual accounts face, we are studying the future will be gradually expanded. "
Asked four ""
Can cumulative reimbursement threshold?
"One patient with a disease seen in the clinic did not optimistic, followed by went to hospitalization, medical insurance reimbursement threshold of how calculated? The patient when seeking medical care at the clinic, it has been calculated according to the threshold of out-patient reimbursement reimbursements, hospital reimbursement after the threshold it possible not to 'double counting'? "has been asked by the representative according to Fang.
Peng Ying-chi also questioned: "the masses are smart, just to, what kind of serious illness was hospitalized for minor illnesses go, it is a liver problem, a result, he Shazi all investigations, anyway, as long as medical costs have exceeded the threshold fee, you can be reimbursed in proportion to their own the burden of less money, this way, the major hospitals are often overcrowded, hospital beds are very nervous. "
Cai Yan replied, "As a rule, the threshold charge is based on the previous year, a 10% pay social level set, and now we are running 2000 standard, it should be said that this has reduced the threshold took, as the same diseases, similar to the time out-patient fees and hospital expenses Levy threshold, there will be a certain level of reduction. "
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