中国城乡统筹医疗保障制度理论与实证研究

发布时间：2018-04-28 01:49

本文选题：城乡统筹 + 基本医疗保险　；参考：《北京大学学报(哲学社会科学版)》2013年05期

【摘要】：中国现行基本医保制度是在计划经济向社会主义市场经济过渡中,由劳保医疗、公费医疗、农村合作医疗等制度转变而来;其主要构成部分为城镇职工社会基本医疗保险、新型农村合作医疗、城镇居民医疗保险。三大基本医保的依次建立将中国居民不断纳入到社会医疗保障体系中,在政策上实现了全民覆盖;但是,现行以户籍、行政区划、就业情况为基本考量的三大基本医保已经不能完全适应社会的发展变化,人口老龄化、城乡一体化发展、卫生费用不断增长等,给现行医疗保障制度带来了严峻的挑战和冲击。本研究在实证调查的基础上,通过定义优良性指标和建立模型,提出了开放型医保体系的经费测算模式和实施方法。研究表明,在经济发展水平不同晋辽地区,将三种医疗保险制度转化为统一制度下的三种医疗保障水平,允许居民自由选择,建立开放型医保可以提高百姓满意度,并能节约政府卫生支出,在理论上证明了可以进行帕累托改进,即政府和居民双方的利益都增加,本研究为卫生改革提供了可资参考的新思维逻辑和技术工具。
[Abstract]:The current basic medical insurance system in China is a transition from planned economy to socialist market economy, resulting from the transformation of such systems as labor insurance, public medical care, rural cooperative medical care, etc. Its main component is the basic social medical insurance for urban workers. New rural cooperative medical insurance, urban residents medical insurance. The establishment of the three major basic medical insurance systems in turn brings Chinese residents into the social medical security system, realizing universal coverage in policy; however, the current household registration, administrative divisions, The three basic medical insurance systems, which take employment as the basic consideration, can not fully adapt to the social development and change. The aging population, the integration of urban and rural development, and the increasing of health care costs have brought severe challenges and impacts to the current medical security system. On the basis of the empirical investigation, the paper puts forward the cost calculation model and implementation method of the open health insurance system by defining the fine index and establishing the model. The study shows that in the areas with different economic development levels, the three medical insurance systems can be transformed into three kinds of medical security levels under the unified system, allowing residents to choose freely, and establishing an open medical insurance system can improve the people's satisfaction. It is proved theoretically that the Pareto improvement can be carried out, that is, the interests of both the government and the residents increase. This study provides a new thinking logic and technical tool for the health reform.
【作者单位】：北京大学医学人文研究院;
【基金】：国家哲学社会科学基金重点项目“城乡医疗统筹背景下我国医疗保障体系问题研究”(项目编号:13AGL010)
【分类号】：C913.7;F842.6

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