我国大病医疗保险问题研究

发布时间：2018-01-30 21:27

本文关键词： 大病保险报销水平经济负担　出处：《东北师范大学》2013年硕士论文　论文类型：学位论文

【摘要】：随着经济的快速发展，人们对生活质量的要求越来越高；然而，市场竞争越来越严重，人们生活压力越来越大，健康成为人们最关注的问题之一。疾病不仅仅给人们的身体带来伤害，同时也给自身家庭带来了很大的经济负担。所以，疾病的影响受到了人们的广泛关注。基于这样的背景，本文对大病和大病保险的概念与内涵进行深入分析，并总结了我国大病医疗保险的发展现状。发现我国大病医疗保险存在着缺乏合理的医疗经费筹措机制和稳定的医疗费用来源、宣传不到位与不适当宣传同时存在、以及商业保险承办大病医疗保险的方式遭质疑的问题。通过分析不难看出这些问题主要是由于我国相关的法律法规不完善、政府投资不足和“次国民待遇”观念根深蒂固等原因造成的。结合英国、德国、印度、和古巴四个国家大病医疗保险的作法，，我们总结了他们的成功经验对我国大病医疗保险发展的启示：应该加强初级医疗网的建设，重视弱势群体和低收入群众的医疗保障；应该坚持公立医疗行业的主导地位，积极发展私立医疗行业；应该加重预防保健在公共卫生医疗服务中的比重。结合上述内容，对完善我国大病医疗保险提出了四条建议：制定大病医疗保险的相关法律政策，规范各地作法；加强对门诊大病管理的配套支持，严格审核管理；加强对合作商业保险的审核，监督和监管商业保险的实施；加速医药改革的进程，做好大病医疗保险配套支持。
[Abstract]:With the rapid development of economy, people are demanding more and more high quality of life. However, the market competition is becoming more and more serious, people live under more and more pressure, health has become one of the most concerned problems. Disease not only brings harm to people's body. At the same time, it also brings a great financial burden to their families. Therefore, the influence of the disease has been widely concerned. Based on this background, the concept and connotation of serious illness and serious illness insurance are deeply analyzed in this paper. And summarized the development of medical insurance of serious illness in China, found that there is a lack of reasonable medical financing mechanism and stable sources of medical expenses in China's serious illness medical insurance. Inadequate publicity and inappropriate publicity simultaneously exist, as well as commercial insurance to undertake serious illness medical insurance is questioned. Through analysis, it is not difficult to see these problems are mainly due to the relevant laws and regulations of our country is not perfect. Inadequate government investment and the concept of "sub-national treatment" deep-rooted and other reasons. Combined with the practices of the four countries of Great Britain, Germany, India and Cuba, we sum up their successful experience to the development of China's medical insurance for serious illness: we should strengthen the construction of primary health care network. Pay attention to the medical security of the vulnerable groups and low-income people; We should adhere to the leading position of the public medical industry and actively develop the private medical industry; The proportion of preventive health care in public health care should be increased. Combined with the above contents, this paper puts forward four suggestions to improve the medical insurance of serious illness in China: to formulate the relevant laws and policies of the medical insurance for serious illness, and to standardize the practices in various places; Strengthen the supporting support to the management of outpatient serious illness, strictly audit management; Strengthen the audit of cooperative commercial insurance, supervise and supervise the implementation of commercial insurance; Speed up the process of medical reform and do a good job of supporting medical insurance for serious illness.
【学位授予单位】：东北师范大学
【学位级别】：硕士
【学位授予年份】：2013
【分类号】：F842.684

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