新型农村合作医疗适度筹资水平研究

发布时间：2018-04-02 02:31

本文选题：新农合筹资　切入点：适度水平　出处：《辽宁大学》2013年硕士论文

【摘要】：新型农村合作医疗作为新的政策制度，不仅是对中国社会保障制度的丰富与完善，更是对农村社会保障体系的创新与改革。因为传统的农村合作医疗已经不能满足农民日益增长的医疗服务需求，农民“看病难、看病贵”的现象愈加突出，严重甚至导致社会不稳定因素产生，基于上述原因，政府相关部门在反复调研、试点的基础上，2003年开始，试点的方式在农村各地推行新型农村合作医，人均筹资水平为30元，2007年此制度在全国范围内普及推广，人均筹资水平为58.9元，参合率为86.2%，到2011年人均筹资水平为246.2元，实现了97%的参合率，基本实现全覆盖目标。截至2012年，保险制度已经运行了10年，一定程度上缓解了农村居民患病就医的经济负担，为维护城乡社会生存公平、农村地区社会稳定、农村经济持续发展等方面起到了积极作用，，更是弥补了农村医疗保障制度的空白。新型农村合作医疗虽然取得了一定的显著成效，但是制度本身依旧存在不完善之处，诸如：筹资水平偏低；筹资没有动态调整机制；筹资与实际医疗需求相脱节等问题。本文尝试在相关理论指导下，通过运用多种统计分析方法，基于农民可支配收入、农民医疗支出、政府财政动态补贴等三方面确定新农合适度筹资水平，并给出两种适度筹资水平方案。在科学分析测算方案的基础上，为提高农村医疗保险水平、全国社会保障水平提出相应的对策与建议。本文主要分为以下五个组成部分：第一部分相关理论概述。通过农村医疗卫生理论和农村医疗保险筹资理论作为新型农村合作医疗保险筹资水平研究的理论基础，并具体细分为：消除城乡二元社会结构理论、城乡社会保障统筹理论、城乡居民生存公平理论、农村居民适度负担理论、医疗保险中的政府责任理论、医疗保险缴费责任的合理分担理论等六个理论，为详细说明和具体测算提供坚实的理论依据。第二部分新农合筹资现状、存在问题及其原因分析。通过说明新农合的运行现状，进而总结新农合筹资存在的一系列问题，并详细分析产生这些问题的原因所在。第三部分新农合适度筹资水平分析。本文的重点部分，基于农民可支配收入的适度筹资水平分析和基于财政动态补贴的适度筹资水平分析，进而测算新农合筹资中各级政府和农民个人缴费责任，确定缴费各方的筹资水平，加总个筹资主体的筹资水平，得到人均筹资水平的一套方案；基于农民医疗支出的适度筹资水平分析，测算出新农合人均筹资水平的第二套方案。第四部分实现新农合适度筹资水平的可行性分析。通过分析农民收入能力、农民医疗支出增长速度、财政支付能力，分析测得方案是否具备现实操作意义。第五部分实现新农合适度筹资水平的政策建议。针对存在问题，根据测算数据，提出加快农村经济发展，提高农民收入；设计农民筹资水平动态调整机制；适度提高政府财政的筹资负担水平；建立农民疾病发生率及病种的信息积累机制；建立与农民医疗需求相适应的医疗供给制度等五点政策建议，为新型农村合作医、农村社会保障制度、甚至为中国社会保障制度改革出谋划策，提供改革方向和政策依据。
[Abstract]:The new rural cooperative medical system as a new policy, not only to China social security system is to enrich and improve the innovation and reform of the rural social security system. Because the traditional rural cooperative medical care has been unable to meet the farmers' growing demand for medical services, farmers "difficult and more expensive" phenomenon is prominent serious and even lead to social instability factors, based on the above reasons, the relevant government departments in the repeated research, on the basis of the pilot, the pilot began in 2003, the implementation of the new rural cooperative medical in rural country, per capita funding level is 30 yuan, in 2007 the system of popularization in the country, per capita funding level is 58.9 yuan. The participation rate was 86.2%, by 2011 the per capita funding level is 246.2 yuan, to achieve 97% of the participation rate, the basic realization of full coverage of the target. As of 2012, the insurance system has been running for 10 In 2013, to a certain extent, it alleviated the economic burden of medical treatment for the rural residents. It played a positive role in maintaining the fairness of urban and rural social existence, the social stability in rural areas, and the sustained development of rural economy. It also made up for the gaps in the rural medical insurance system.
Although the new rural cooperative medical system has achieved remarkable results in certain, but the system itself is still not perfect, such as: low level of financing; financing no dynamic adjustment mechanism; financing is divorced from the actual medical needs and other issues. This paper attempts in the related theory, by using various statistical analysis methods, based on the disposable income of farmers. The farmers' medical expenditure, government financial subsidies and other three aspects to determine the dynamic system appropriate funding levels, and gives two kinds of moderate level of financing scheme. The calculation based on the scientific analysis methods, in order to improve the rural medical insurance level, put forward the corresponding countermeasures and suggestions of the national level of social security.
This article is divided into the following five components:
The first part is an overview of the relevant theory. The theoretical basis of rural health theory and rural medical insurance financing theory as the new rural cooperative medical insurance funding level study, and is divided into: the elimination of two urban and rural dual social structure theory, urban and rural social security theory, the theory of survival fairness between urban and rural residents, rural residents moderate burden theory, theory of government the responsibility of medical insurance, medical insurance payment responsibility allocation theory of the six theories, provide a solid theoretical basis for a detailed description and specific calculation.
The second part is about the financing status, existing problems and causes of NRCMS. By explaining the operation status of NCMS, we sum up a series of problems existing in NCMS financing, and analyze the reasons for these problems in detail.
The third part of the NCMS moderate level of financing analysis. The key part of this paper, a moderate level of financing of the disposable income of farmers and the appropriate level of funding financial subsidies based on dynamic analysis and calculation based on the NCMS funding in all levels of government and farmer individual responsibility, determine the level of financing payment of all parties, the level of funding total financing subject, get a scheme of per capita funding level; analysis of moderate level of financing farmers medical expenditure based on the estimated second scheme NCMS per capita funding level.
The fourth part is the feasibility analysis of the appropriate financing level of the new rural cooperative medical system. By analyzing the farmers' income ability, the growth rate of medical expenditure and the financial payment ability of farmers, it is analyzed whether the measurement has practical operation significance.
The new rural cooperative medical funding level moderate policy recommendations to achieve the fifth part. In view of the existing problems, put forward according to the measure data, accelerate the development of rural economy and increase farmers' income; the level of the dynamic adjustment mechanism of farmers financing design; increase the fiscal burden of financing level; establishing farmers' disease incidence and disease information accumulation mechanism; the establishment of medical supply system etc. five suggestions to adapt to the medical needs of farmers, the new rural cooperative medical, rural social security system, even for the reform of the system of social security China give advice and suggestions, provide the reform direction and policy basis.

【学位授予单位】：辽宁大学
【学位级别】：硕士
【学位授予年份】：2013
【分类号】：F323.89;F842.684;R197.1

【参考文献】