城乡统筹下的江苏省基本医疗保险体制改革研究

发布时间：2018-02-12 04:01

本文关键词： 城乡统筹医疗保险改革　出处：《南京理工大学》2013年硕士论文　论文类型：学位论文

【摘要】：建国至今,中国的社会医疗保险制度不断发展,已经形成了“三个保障体系加个救助体系”的医疗保险体系(城镇职工基本医疗保险、城镇居民基本医疗保险、新型农村合作医疗和社会医疗救助相结合),从政策制度上看我国已经覆盖了城乡全体公民,但这仅是在制度体系上覆盖了全民而已,在实际经办和政策执行中仍有很多问题需要亟待解决。如三种不同的医疗保障制度之间和政府管理部门之间,都有一些有悖公平和效率的问题,需要进一步的完善。因此只有全面建立城乡统筹的医疗保障体系才能使全民医保真正落实到位。目前我国的医疗保障的主要管理部门是由社会保障、卫生、民政三部门具体管理,与此同时财政、国家发展改革委员会、农业、药监等部门也参与对各种政策、制度的分管,多单位的参与造成了“多龙戏水”,却没有一个可以全面整合政策,同时又能协调医疗保障责任的部门。这些机构的分设,又造成了公共管理成本的增加,资源大量浪费,保险运行效率降低。本文试图就医疗保险城乡统筹所需条件和阻力方面进行研究。首先对国内外医疗保障制度的发展现状进行阐述比较；其次从整合的主观动能和客观条件两个角度分析,剖析国家和江苏省的医疗保险城乡统筹的总体形势、存在的主要问题,以及导致这些问题的主要原因。最后文中将使用医疗保险学、经济学、公共组织理论等相关理论,根据现有国情、省情,提出进一步完善城乡统筹的医疗保障制度的整合对策。
[Abstract]:Since the founding of the people's Republic of China, China's social medical insurance system has developed continuously, and has formed a medical insurance system of "three security systems plus a relief system" (basic medical insurance for urban workers, basic medical insurance for urban residents, and basic medical insurance for urban residents). The combination of new rural cooperative medical care and social medical assistance has covered all citizens in both urban and rural areas in terms of policy and system, but this has only covered the whole people in the system. There are still many problems to be solved in the actual operation and policy implementation. For example, between three different medical security systems and between government administration departments, there are some problems that are contrary to fairness and efficiency. Therefore, only the overall establishment of urban and rural overall medical security system can make the health insurance for all really put in place. At present, the main administrative departments of medical security in China are specifically managed by the three departments of social security, health and civil affairs. At the same time, the departments of finance, the National Development and Reform Commission, agriculture, drug control, and other departments are also involved in the management of various policies and systems. The participation of many units has created a "multi-dragon water", but there is no department that can fully integrate the policy and at the same time coordinate the responsibility for health care. The division of these institutions has resulted in an increase in the cost of public administration and a huge waste of resources. The efficiency of insurance operation is reduced. This paper attempts to study the necessary conditions and resistance of medical insurance in urban and rural areas. Firstly, it expounds and compares the development status of medical security system at home and abroad; secondly, it analyzes from two angles of subjective kinetic energy and objective conditions of integration. This paper analyzes the overall situation, the main problems and the main causes of the overall urban and rural planning of medical insurance in China and Jiangsu Province. In the end, we will use relevant theories such as medical insurance, economics, public organization theory, etc. According to the existing national conditions and provincial conditions, the author puts forward the integrated countermeasures to improve the medical security system as a whole in urban and rural areas.
【学位授予单位】：南京理工大学
【学位级别】：硕士
【学位授予年份】：2013
【分类号】：F842.6

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