昆明市城乡统筹基本医疗保障制度研究

发布时间：2018-03-05 03:36

本文选题：医疗保障　切入点：城乡二元割裂　出处：《云南大学》2013年硕士论文　论文类型：学位论文

【摘要】：医疗保险制度改革的建立健全是一个世界性的难题,也是一项浩繁的系统工程,尤其是在中国这样一个人口多、底子薄的大国。虽然现行的医疗保险制度开创了前无古人的事业,但并不是我们的理想目标。我国现行医疗保险制度以城乡、地区、职业和人群为分割要素,造成医疗待遇水平差异很大的城乡二元割裂格局,既违背公平和效率原则,也越来越不适应我国经济社会的日益发展和市场经济对医疗保险制度的一元化需求。党中央、国务院高度重视整合医疗保险制度这项工作,这项工作已势在必行,可以在消除医疗保险的城乡二元割裂格局的同时,以达到促进实现城乡统筹发展的目标。在这样的背景下,本文以公共产品理论、福利经济学及社会分层理论作为理论基础,以昆明市城乡统筹医疗保障制度为研究目标,通过对现行制度差异性的比较分析,讨论昆明市实施城乡统筹医疗保险制度的必要性和可行性,并探讨如何根据自身情况选择一条适合自己的城乡统筹医疗保险制度之路。力图讨论在城乡统筹并最终实现城乡一体化这个过程中,如何平衡城乡统筹医疗保险制度与职工医疗保险制度两者的关系,不是延续以往的“打补丁”式的制度设计方法,而是构建出一个可持续性的制度运行框架,最大程度避免两个制度之间形成的摩擦和各种障碍,尽可能既实现社会公平,又能最大程度提高公共管理效率。全文共分7章,其基本框架如下：第1章：绪论,从中国城乡医疗保障制度“二元三分”格局的形成入手,介绍研究背景、研究意义、研究方法等；第2章：理论基础与文献综述。介绍了文章的理论基础公共产品、福利经济学及社会分层理论,对几组相关概念进行界定,并对城乡统筹基本医疗保障制度研究的相关文献做了述评；第3章：昆明市城乡医疗保障制度的差异分析,梳理了昆明市医疗保险制度发展情况,同时对制度间差异进行比较分析,认为昆明市医疗保险事业取得成绩的同时,也面临着很多挑战与问题；第4章：国内外城乡统筹医疗保障制度的经验借鉴,通过对国内外典型案例的分析,从中梳理了对昆明市实施城乡居民基本医疗保险可借鉴的经验；第5章：昆明市城乡统筹基本医疗保障制度实施的必要性和可行性分析；第6章：昆明市城乡统筹基本医疗保障制度的框架设计；重点描述了筹资方案和补偿方案的设计思路及确定方案。第7章：结语及展望,总结了昆明市实施城乡统筹医疗保障制度的现状,同时展望了后续可供研究的问题。
[Abstract]:The establishment and improvement of the medical insurance system reform is a worldwide problem and a huge systematic project, especially in China with such a large population. Although the current medical insurance system has created an unprecedented cause, it is not our ideal goal. The current medical insurance system in our country is divided into urban and rural areas, regions, occupations and people. The dichotomy pattern between urban and rural areas, which leads to great differences in medical treatment level, is not only against the principles of fairness and efficiency, but also more and more unsuited to the growing economic and social development of our country and the unified demand of the market economy for the medical insurance system. The State Council attaches great importance to the work of integrating the medical insurance system, which is imperative. It can eliminate the urban-rural split pattern of medical insurance and at the same time achieve the goal of promoting the overall development of urban and rural areas. In this context, Based on the theory of public goods, welfare economics and social stratification theory, this paper takes the urban and rural medical security system of Kunming as the research goal, through the comparative analysis of the differences of the current system. The necessity and feasibility of implementing the urban and rural medical insurance system in Kunming are discussed. It also discusses how to choose a suitable way of urban-rural overall medical insurance system according to its own situation. It tries to discuss the process of urban-rural planning and finally realizing urban-rural integration. How to balance the relationship between urban and rural medical insurance system and employee medical insurance system is not a continuation of the previous "patching" system design method, but a sustainable framework of system operation. To the greatest extent, the friction and obstacles between the two systems can be avoided, and the social equity and the efficiency of public administration can be improved as much as possible. This paper is divided into seven chapters, its basic framework is as follows:. Chapter 1: introduction, starting from the formation of the "dual three-point" pattern of China's urban and rural medical security system, introduces the research background, research significance, research methods and so on. Chapter 2: theoretical basis and literature review. This paper introduces the theoretical basis of public goods, welfare economics and social stratification theory, and defines several related concepts. It also reviews the relevant documents of the study on the basic medical security system in urban and rural areas. Chapter 3: the analysis of the difference between urban and rural medical security system in Kunming, combing the development of medical insurance system in Kunming, at the same time, comparing the differences between the systems, and considering that Kunming medical insurance industry has made achievements at the same time, Also facing many challenges and problems; Chapter 4: the experience of urban and rural health insurance system at home and abroad, through the analysis of typical cases at home and abroad, combing the basic medical insurance for urban and rural residents in Kunming can learn from the experience; Chapter 5: the necessity and feasibility analysis of urban and rural basic medical security system in Kunming; Chapter 6: the frame design of the basic medical security system of urban and rural planning in Kunming, with emphasis on the design and determination of the financing scheme and the compensation scheme. Chapter 7: conclusion and prospect, summarizes the current situation of urban and rural medical security system in Kunming, and looks forward to the problems to be studied in the future.
【学位授予单位】：云南大学
【学位级别】：硕士
【学位授予年份】：2013
【分类号】：F842.684;R197.1

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