上海城乡一体化的基本医疗保险体系研究

发布时间：2018-05-24 03:14

本文选题：基本医疗保险 + 体系构建　；参考：《上海工程技术大学》2014年硕士论文

【摘要】：城乡二元分割的基本医疗保险制度，不仅影响了我国城市化的进程，也影响了基本医疗保险制度运行的公平和效率，完善基本医疗保险制度也是社会保障领域的热点问题之一。论文选取经济发展水平较高的上海为例，研究上海城乡一体化的基本医疗保险体系构建，也具有典型的代表性。论文通过对上海基本医疗保险制度的历史沿革及现状研究，分析现在上海基本医疗保险体系中三大基本医疗保险存在的问题与不足，通过分析得知上海三大基本医疗保险在筹资模式、筹资水平、补偿项目和补偿水平存在的差异。接下来研究了城乡一体化体系构建过程中的责任分担主体——政府、企业和个人，并对它们的责任分担机制研究，强调政府在体系构建过程中的重要作用。本文梳理了上海基本三大基本医疗保险制度的发展历程及运行现状，剖析现有制度的不足；同时，对城乡基本医疗保险的情况和居民对一体化的态度进行了调研，运用定量分析方法对结果分析，得出了相关结论，为构建上海基本医疗保险一体化体系提供了实证证据；研究了国内外城乡基本医疗保险城乡一体化的做法及对上海的经验启示。构建上海城乡一体化的基本医疗保险体系，应当遵循政府主导、逐步过渡的原则，构建上海梯度发展的城乡一体化体系。在这个体系中，通过基础平台和多层次辅助平台的设计，打破城乡之间的二元限制。基础平台制定了合理的缴费标准，即以城镇居民16-60岁之间的人群缴费水平为基础平台的缴费水平，对于农村居民不足部分由政府承担。辅助平台的设计是根据个人需要和经济发展水平自由选择不同水平档的缴费，同时享受与之相对应地补偿待遇，，并以个人、企业及政府的缴费能力为切入点对这一体系设计进行验证与修正。随着经济发展水平的提高，新农合和城镇居民将逐渐并轨统一，并将与城镇居民的运行并轨，最终实现上海基本医疗保险体系的完全城乡一体化。最后，对构建上海基本医疗保险城乡一体化后上海基本医疗保险体系的可持续发展从经济、政策、人口三个因素进行了验证，提出了完善上海基本医疗保险城乡一体化运行的对策与建议。
[Abstract]:The dual division of urban and rural basic medical insurance system not only affects the process of urbanization in China, but also affects the fairness and efficiency of the operation of basic medical insurance system. Perfecting the basic medical insurance system is also one of the hot issues in the field of social security. This paper takes Shanghai with a high level of economic development as an example to study the construction of the basic medical insurance system of urban and rural integration in Shanghai, which is also typical. By studying the history and current situation of the basic medical insurance system in Shanghai, this paper analyzes the problems and shortcomings of the three basic medical insurance systems in Shanghai. Through the analysis of the three major basic medical insurance in Shanghai in financing mode, funding level, compensation project and compensation level of differences. Then it studies the main body of responsibility sharing in the process of constructing urban-rural integration system-government, enterprises and individuals, and studies their responsibility-sharing mechanism, emphasizing the important role of government in the process of system construction. This article combs the basic three basic medical insurance system in Shanghai, analyzes the current situation of the basic medical insurance system, analyzes the deficiency of the existing system, and investigates the situation of the basic medical insurance in urban and rural areas and the residents' attitude towards integration. The quantitative analysis method is used to analyze the results, and the relevant conclusions are drawn, which provide empirical evidence for the construction of Shanghai basic medical insurance integration system. This paper studies the practice of urban-rural integration of urban and rural basic medical insurance at home and abroad and its enlightenment to Shanghai. To construct the basic medical insurance system of urban and rural integration in Shanghai, we should follow the principle of government leading and transition step by step, and construct the urban and rural integration system with gradient development in Shanghai. In this system, the dual restriction between urban and rural areas is broken through the design of basic platform and multi-level auxiliary platform. The basic platform formulates the reasonable standard of payment, which is based on the level of the urban residents between 16 and 60 years old, and the government undertakes the insufficient part of the rural residents. The auxiliary platform is designed to freely select contributions from different levels according to individual needs and level of economic development, and at the same time enjoy the corresponding compensation treatment and individual, Enterprises and the government's ability to pay for the entry point of this system design verification and revision. With the improvement of the level of economic development, NCMS and urban residents will be unified gradually, and the operation of urban residents will be integrated with the operation of urban residents, finally realizing the complete integration of urban and rural areas of the basic medical insurance system in Shanghai. Finally, the paper verifies the sustainable development of Shanghai basic medical insurance system in terms of economy, policy and population after the construction of urban and rural integration of basic medical insurance in Shanghai. The countermeasures and suggestions to improve the urban and rural integration of basic medical insurance in Shanghai are put forward.
【学位授予单位】：上海工程技术大学
【学位级别】：硕士
【学位授予年份】：2014
【分类号】：F842.684

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