关于上海市职工医疗制度改革目标模式的探讨

国际上有两种保险模式：一种是新加坡和美国的“保大放小”模式，只对高风险基本医疗实行社会保险制度；另一种是德国和法国的“全统全保”模式，对所有基本医疗均实行社会保险制度。上海市职工医疗制度改革目标模式应该是“大病保险社会化、补充保险体系化、医疗救助制度化”。上海市社会医疗保险的保险内容应该是职工住院医疗，高费用门诊医疗和退休职工一般门诊医疗。

An exploration on the target model of the reform of Shanghai employee and government staff medical system

There are two medical insurance models in the world. one is the model of Singapore and USA, which the social medical insurance only covers high-risk essential medical. Another is the model of Germany and France, which covers all essential medical. The target model of the reform of Shanghai employee and governmnt staff medical system should be socialized insurance for high-risk essential medical, with systematic supplemental insurance and legal medical aids. Shanghai medical insurance system should cover in-patient essential medical, high-risk oupatient essential mwhcal and outpatient essential medical of the retital.