神木医改以近乎完全政府化的包办方式操作因不具备可持续性和可推广性引起了极大的争议。在当前中国政府财力还十分有限的情况下,政府还不具备包办全体居民医疗服务需求的能力,必须通过有效的综合的制度设计,建立由政府主导医疗体制改革,医院、患者、保险机构和政府合理分担居民的医疗费用的机制。在居民收入信息公开透明的情况下,本文设想了一个通过医药分离、保险支付、政府补助三级分流的模式,既可以保证中国绝大部分居民可以承担医疗支出费用,又可以使得政府的负担最小化,很好地兼顾公平与效率。 Shenmu medical reform to almost completely government-run way to operate because of lack of sustainability and can promote a great controversy. At a time when the financial resources of the Chinese government are still very limited, the government still does not have the ability to handle the needs of all residents in medical services. Therefore, it is necessary to establish a government-led medical system reform through effective and integrated system design, with hospitals, patients, insurance agencies and governments Reasonable sharing of medical expenses of residents mechanism. In the case of open and transparent residents’ income information, this paper envisions a three-level diversion model that divides medicine, insurance and government grants to ensure that the vast majority of residents in China can afford medical expenses and minimize the government burden To achieve fairness and efficiency.