大病保险中政府与市场关系研究

发布时间：2018-02-07 11:00

本文关键词： 大病保险政府市场商业健康保险　出处：《苏州大学》2014年硕士论文　论文类型：学位论文

【摘要】：经过多年的发展，我国覆盖城乡的基本医疗保险制度已经基本建成，与医疗救助、其他各形式补充医疗共同形成了多层次医疗保障体系。然而，基本医疗在重大疾病的保障方面所有缺失。对于大病患者而言，个人负担重，极易出现因病致贫、因病返贫现象。 2012年8月，六部委联合发布《关于开展城乡居民大病保险工作的指导意见》，利用城乡居民基本医保基金，由国家向商业保险机构购买服务，在全国范围内探索建立面向城乡居民的二次补偿大病保险制度。目前大病保险在全国范围内进入了实践探索阶段。在此背景下，本文旨在定位大病补充医疗保险中政府和市场的关系和职责担当。在对大病、政府与市场各自的内涵进行界定的基础上，分析多层次医疗保障体系建立的理论意义以及借鉴国际经验对各个层次的医疗保障模块中政府市场的职责进行定位。在上述研究的支撑下，结合我国计划经济时期以来对于重大疾病的保障措施，分析了大病补充保险出现的原因主要是基本医疗保障能力不足。就国内已有的大病保险具体实践中政府和市场的实际关系进行解析并提出建议，应充分发挥市场在大病补充医疗保险中的效率作用，将大病保险放手给商保公司主办，，由个人自愿购买，政府则负责提高基本医疗保障的水平并提供有序化和健康化的医疗保险市场环境。
[Abstract]:After years of development, the basic medical insurance system covering urban and rural areas in China has basically been built, and a multi-level medical security system has been formed together with medical assistance and other forms of supplementary medical care. For the patients with serious diseases, the personal burden is heavy and it is easy to cause poverty due to illness and return to poverty because of illness. In August 2012, the six ministries and commissions jointly issued the guidelines on the Development of Major illness Insurance for Urban and Rural residents, using the basic Medical Insurance Fund for Urban and Rural residents to purchase services from commercial insurance institutions by the state. This paper explores the establishment of a secondary compensation insurance system for urban and rural residents throughout the country. At present, serious illness insurance has entered the stage of practical exploration throughout the country. The purpose of this paper is to define the relationship and responsibility between government and market in supplementary medical insurance for serious illness. On the basis of defining the connotation of serious illness, government and market, This paper analyzes the theoretical significance of the establishment of multi-level medical security system and uses international experience for reference to position the responsibility of the government market in various levels of medical security modules. Combined with the safeguard measures for major diseases since the planned economy period in China, This paper analyzes the main reasons for the occurrence of supplementary insurance for serious illness, mainly the insufficiency of basic medical security, analyzes the actual relationship between the government and the market in the actual practice of the serious illness insurance in China, and puts forward some suggestions. We should give full play to the efficiency role of the market in supplementary medical insurance for serious illness, and let go of the insurance for serious illness to be sponsored by insurance companies and purchased voluntarily by individuals. The government is responsible for raising the level of basic health care and providing an orderly and healthy health care market environment.
【学位授予单位】：苏州大学
【学位级别】：硕士
【学位授予年份】：2014
【分类号】：F842.684;R197.1

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