我国城乡居民医疗保险一体化制度研究

发布时间：2018-03-17 05:06

本文选题：城镇居民医疗保险　切入点：新型农村合作医疗保险　出处：《新疆财经大学》2013年硕士论文　论文类型：学位论文

【摘要】：在中共十八大上，胡锦涛主席明确提出，要“统筹推进城乡社会保障建设”。社会保险问题作为社会保障的重要组成部分，在维护社会稳定、建设和谐社会方面发挥了积极的作用。医疗保险又作为社会保险的分支，有效地解决了广大居民“看病贵、看病难”的问题。长期以来，由于我国特殊的二元经济和社会结构，由城镇职工医疗保险、城镇居民医疗保险和新型农村合作医疗保险组成的三大主体医疗保险制度虽然在相当程度上实现了全覆盖，但是制度的城乡二元结构和碎片状现象却很明显，医疗卫生资源严重分配不均，农村居民同样作为平等自由的个体而无法享受到与城镇居民相同的医保待遇，违背了公平享有改革开放成果的原则。随着城镇化的深入发展，农村居民的生活水平有了很大的提高，要求缩小城乡差别、平等享有医疗卫生资源的诉求受到广大专家学者的关注。因此，探索建立一体化的医疗保险制度，实现制度在城乡居民间的公平普惠，就顺应了当前城乡一体化的发展趋势。城镇职工医疗保险制度、城镇居民医疗保险制度和新型农村合作医疗保险制度共同构成了我国医疗保险制度的“三驾马车”。基于城镇居民医疗保险和新型农村合作医疗保险在居民收入水平、保障层次等方面有诸多相似性，并且在诸如新疆、浙江等地区也已开始着手筹备二者并轨相关的制度设计问题，因此又具有现实可能性。因此，本文主要探讨城镇居民医疗保险和新型农村合作医疗保险的一体化问题，运用比较分析法、归纳分析法和文献分析法进行阐释。从关于城乡居民医疗保险制度一体化的相关理论研究和观点出发，依据当前我国的基本医疗保险现状,指出当前城乡居民医疗保险和新型农村合作医疗保险制度存在诸多问题,并分析问题的成因可能是我国特殊的城乡二元经济结构造成的,进而提出了构建城乡居民医疗保险一体化制度的设想。在此基础上，借鉴国内外城乡居民医疗保险一体化制度的经验，提出对我国建立医疗保险一体化制度的启示，，并论证了城镇居民医保与新农合并轨的必要性与可行性，给出了提高居民医疗保险基金统筹层次和鼓励商业保险加入市场参与竞争的现实选择。最后提出建立城乡居民医疗保险一体化制度的相关对策建议。由于辽宁省大连市是全国开展这三种医疗保险的早期试点城市之一，又经过这几年的发展，数据比较全面，制度比较完善，具有一定的代表性，因而，为了便于分析，本文主要以大连市为例。
[Abstract]:At the 18 National Congress of the Communist Party of China (CPC), President Hu Jintao made it clear that it is necessary to "promote the construction of social security in urban and rural areas as a whole." as an important part of social security, the issue of social insurance is maintaining social stability. The construction of a harmonious society has played a positive role. As a branch of social insurance, medical insurance has effectively solved the problem of "expensive and difficult to see a doctor" for the vast number of residents. For a long time, due to the special dual economy and social structure of our country, Although the three major medical insurance systems, consisting of urban worker medical insurance, urban resident medical insurance and new rural cooperative medical insurance, have achieved full coverage to a considerable extent, But the urban-rural dual structure of the system and the phenomenon of fragmentation are very obvious. Medical and health resources are severely unevenly distributed, and rural residents, as equal and free individuals, are unable to enjoy the same medical insurance treatment as urban residents. Contrary to the principle of equitable enjoyment of the fruits of reform and opening up. With the further development of urbanization, the living standards of rural residents have been greatly improved, requiring narrowing the gap between urban and rural areas. The appeal of equal access to medical and health resources has attracted the attention of experts and scholars. Therefore, to explore the establishment of an integrated medical insurance system and to realize the fair and inclusive system between urban and rural residents conforms to the current development trend of urban-rural integration. The medical insurance system for urban workers, The urban residents medical insurance system and the new rural cooperative medical insurance system constitute the "troika" of the medical insurance system of our country. Based on the income level of the urban residents medical insurance and the new rural cooperative medical insurance, There are many similarities in the level of security, and in regions such as Xinjiang and Zhejiang, they have already begun to prepare for the system design problems related to the integration of the two, so there is a realistic possibility. This paper mainly discusses the integration of the urban residents' medical insurance and the new rural cooperative medical insurance, and applies the comparative analysis method. Based on the relevant theoretical research and viewpoints on the integration of urban and rural residents' medical insurance system, according to the current situation of basic medical insurance in China, This paper points out that there are many problems in the current medical insurance system of urban and rural residents and the new rural cooperative medical insurance system, and analyzes that the causes of the problems may be caused by the special urban-rural dual economic structure in China. On the basis of this, the author draws lessons from the experience of the integration system of medical insurance between urban and rural residents at home and abroad, and puts forward the enlightenment to the establishment of medical insurance integration system in China. It also demonstrates the necessity and feasibility of the integration of medical insurance for urban residents and new agricultural cooperation. This paper gives the realistic choice of raising the overall planning level of residents' medical insurance fund and encouraging commercial insurance to join the market to participate in the competition. Finally, it puts forward the relevant countermeasures and suggestions for establishing the integration system of urban and rural residents' medical insurance. Dalian is one of the early pilot cities in China to launch these three kinds of medical insurance. After several years of development, the data is more comprehensive, the system is more perfect, and has a certain representativeness. Therefore, in order to facilitate the analysis, this paper mainly takes Dalian as an example.
【学位授予单位】：新疆财经大学
【学位级别】：硕士
【学位授予年份】：2013
【分类号】：F842.684

【参考文献】