北京市村卫生室实施新农合制度过程中存在的法律问题与对策

北京市的部分远郊区县，将村卫生室纳入新农合门诊统筹实施范围，这是与在村卫生室执行零差价药物制度和提供公共卫生服务相结合的基础上开展的。该措施在准入门槛和批准程序上较为宽松，但在补偿机制方面却不够科学合理，使得一些医疗技术较好的村卫生室游离在定点村卫生室范围外。同时，定点村卫生室的村医还存在不规范的执业行为。究其原因，这是由于法人代表在责任归属等问题方面职责不清，在一定程度上影响了定点村卫生室基本医疗服务的开展。为此，未来法律应当对不同类别的村卫生室的性质和地位做出规定，明确其各自承担的法律义务和责任，完善准入条件和补偿方式，加强对定点村卫生室执业行为的监管。

Legal Questions and Suggestions in the Process of the Implementation of New Rural Cooperative Medical System in Bejing Village Clinics

In Beijing, some village clinics have been made into the implementation of New Rural Cooperative Medical System since the begin- ning, at the same time, these medical sectors/nust provide the public health services and essential medicines. Though the lower level of subsidy and the lack of effective performance evaluation system in this area provide a reverse incentive for country doctors and result in widespread perfunctory form and irresponsibility. In order to turn things around, entry criteria for providing public health services should be upgraded, performance evalua- tion test be improved and the way government subsidies granted refined. The government also should strengthen the supervision of these Village Clinics.