基于伦理因素的城乡基本医疗保险制度并轨研究

发布时间：2018-03-18 22:41

本文选题：基本医疗保障制度　切入点：政策并轨　出处：《东南大学》2017年硕士论文　论文类型：学位论文

【摘要】：十八大以来,中央提出"健康中国"的发展理念,本研究在充分研究基本医疗保障制度运行情况和伦理因素相关问题文献资料的基础上,从伦理影响因素分析,以南京市浦口区开展的城乡基本医疗保障制度并轨为案例,以理论和实践紧密结合的研究方法,全面系统研究城乡基本医疗保障制度并轨的伦理角度下的家庭、城乡二元结构传统、公平性和平均主义、政府责任等伦理因素,以此创新和拓宽城乡基本医疗保障制度并轨的内涵,推进城乡基本医疗保障制度并轨政策的改革和建设,为各地推进城乡基本医疗保障制度并轨提供建议。本研究共有六章。第一章为导论,对西方主要国家的基本医疗保障情况,国内关于城乡基本医疗保险并轨的研究、公共管理伦理、生命伦理等文献研究基本现状。第二章主要结合南京市浦口区在2014年实施的城镇居民医保和新型农村合作医疗制度并轨政策实施,采取的管理措施,运用文献研究法并对并轨后的制度实施、基金运行情况进行分析,采取走访调查法对部分城镇居民和农村居民进行调查研究,得出了并轨中存在的城镇居民和农村居民就医习惯存在差异,农村居民反哺城镇居民的"穷帮富"现象,以及医疗总费用上升过快,并轨后城乡居民医疗保健需求得到释放等主要问题。第三章从传统家庭成员间的分化进行伦理因素分析出家庭成员间道德风险加剧等问题。第四章从城乡二元结构因素分析对基本医疗保障制度并轨的影响,得出了城乡一体化发展必须首先实现对人的价值的统一,以人为本的制定城乡统一的医疗保障政策。第五章从公平性和平均主义的伦理因素解读分析公平性与保大病之间的矛盾,"效率优先兼顾公平"不适用于基本医疗保障,平均主义对困难人群的保障不足。第六章从政府责任分析必须建立服务型组织,防范道德风险,建立医疗保障制度的动态调节机制才能保证基本医疗保障制度的可持续发展。提出了以家庭为单元构建各种医疗保障制度间的基金流通机制,使人人享有公平的基本医疗保障服务的建议。
[Abstract]:Since the 18 National Congress, the Central Committee has put forward the development concept of "healthy China". Based on the full study of the operation of the basic medical security system and the related issues related to ethical factors, this study analyzes the ethical influence factors. Taking the integration of urban and rural basic medical security systems in Pukou District of Nanjing as a case study, and using the research method of close combination of theory and practice, this paper comprehensively and systematically studies the families under the ethical perspective of the integration of urban and rural basic medical security systems. The traditional dual structure of urban and rural areas, fairness and equalitarianism, government responsibility and other ethical factors, so as to innovate and broaden the connotation of the basic medical security system in urban and rural areas, and promote the reform and construction of the policy of merging the basic medical security system in urban and rural areas. This study consists of six chapters. The first chapter is an introduction to the basic medical security situation in major western countries, and the domestic research on the integration of urban and rural basic medical insurance. The second chapter mainly combines the policy of urban residents medical insurance and the new rural cooperative medical system implemented in 2014 in Pukou District, Nanjing City, to take management measures. By using the method of literature research and the implementation of the system after the merger, the operation of the fund is analyzed, and some urban and rural residents are investigated and studied by the method of visiting and investigating. It is concluded that there are differences in the habit of seeking medical treatment between the urban residents and the rural residents, the phenomenon of rural residents feeding the poor and helping the rich to urban residents, and the increase of the total medical expenses are too fast. The third chapter analyzes the ethical factors of the division of traditional family members, and analyzes the problems of increasing moral hazard among family members. Chapter 4th combines urban and rural areas. The influence of structural factor analysis on the integration of basic medical security system, It is concluded that the development of urban-rural integration must first realize the unification of human values. The 5th chapter analyzes the contradiction between fairness and serious illness from the perspective of fairness and egalitarianism. "efficiency gives priority to fairness" does not apply to basic medical security. Egalitarianism does not protect the needy. Chapter 6th: from the analysis of government responsibility, we must establish service-oriented organizations to guard against moral hazard. Only by establishing the dynamic adjustment mechanism of the medical security system can the sustainable development of the basic medical security system be ensured. Proposals for equitable access to basic health care services for all
【学位授予单位】：东南大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：F842.684

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