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东营市统筹城乡居民医疗保险改革研究

发布时间:2018-06-29 07:40

  本文选题:城乡居民医疗保险 + 政策体系 ; 参考:《新疆大学》2017年硕士论文


【摘要】:我国自1998年、2003年相继建立了城镇职工医疗保险制度和新型农村合作医疗制度,将城镇职工和农村居民纳入了保障范围。在两项制度取得良好成效的基础上,2007年,国务院面向全国,选取了79个城市开展城镇居民医疗保险试点。东营市作为其中一员,于2007年10月份,实施了城镇居民医疗保险制度,率先构建了由城镇职工医疗保险、城镇居民医疗保险、新型农村合作医疗三项制度组成的医疗保障体系,在制度上实现了全覆盖。2012年,针对城镇居民医疗保险和新型农村合作医疗制度分设所带来的各种弊端,东营市积极借鉴先进地区经验,结合实际,创新思路,在全省率先完成了城镇居民医疗保险与新型农村合作医疗的统筹整合,将居民医疗保障体系从“双轨制”转变为“一张网”,建立了统筹城乡的居民医疗保险制度。后期,针对制度运行中出现的居民医保基金支出增长过快问题,东营市历时一年探索建立了总额控制下的组合式付费方式,实现了城乡居民医疗保险制度的良性、健康、可持续发展。东营市城乡居民医疗保险制度从政策体系的建立健全到运行体制机制的逐步优化,各项改革工作取得了良好的社会效果,为其他地区居民基本医疗保险制度的发展提供了宝贵经验。然而,随着经济社会的不断发展和各项改革的逐渐深入,东营市的城乡居民医疗保险事业遇到了不少问题。比如,筹资机制如何完善、统筹后的居民医保基金如何实现收支平衡、基层医疗卫生服务体系建设如何加强、怎样构建针对老年参保群体的长期照护保险制度等等。因此,本文以东营市统筹城乡居民医疗保险改革研究为题,以公共产品、福利经济学、社会公平与服务均等化理论为基础,通过文献分析、比较研究、实地调研和归纳演绎等多种研究方法,深入分析研究东营市统筹城乡居民基本医疗保险工作的现状、问题及对策建议,旨在为丰富我国城乡居民基本医疗保险统筹发展、改革发展的有关理论,为包括东营市在内的其他地区居民医疗保险事业的进一步发展做出积极贡献。本文第一章为引言部分,第二章主要介绍了统筹城乡居民医疗保险的概念界定与理论基础,第三章为东营市开展统筹城乡居民医疗保险的改革内容和改革方式,第四章主要探究东营市城乡居民医疗保险发展存在的问题并分析其产生原因,第五章为先进地区的经验借鉴,第六章有针对性地对东营市城乡居民医疗保险的改革完善提出个人的对策建议。
[Abstract]:Since 1998 and 2003, China has established the urban worker medical insurance system and the new rural cooperative medical insurance system, which brings the urban workers and rural residents into the scope of security. On the basis of the good results of the two systems, in 2007, the State Council selected 79 cities to carry out the pilot program of urban residents' medical insurance. Dongying City, as one of them, implemented the medical insurance system for urban residents in October 2007, and took the lead in constructing a medical security system consisting of three systems, namely, medical insurance for urban workers, medical insurance for urban residents, and new rural cooperative medical insurance. In 2012, in view of the various drawbacks brought by the separation of urban residents' medical insurance and the new rural cooperative medical care system, Dongying actively drew lessons from the experience of advanced regions, combined with the actual situation, and innovated ideas. In the whole province, the urban residents' medical insurance and the new rural cooperative medical insurance were first integrated, the residents' medical insurance system was changed from "two-track system" to "one net", and the urban and rural residents' medical insurance system was established as a whole. In the later period, in view of the problem of the residents' medical insurance fund expenditure increasing too fast, Dongying City spent a year exploring the establishment of a combined payment method under the control of total amount, which realized the benign and healthy medical insurance system of urban and rural residents. Sustainable development The medical insurance system for urban and rural residents in Dongying City has achieved good social results from the establishment of a sound policy system to the gradual optimization of the operational system mechanism. It provides valuable experience for the development of basic medical insurance system in other areas. However, with the continuous development of economy and society and the deepening of various reforms, the medical insurance of urban and rural residents in Dongying has encountered many problems. For example, how to perfect the financing mechanism, how to balance the income and expenditure of the residents' health insurance fund, how to strengthen the construction of the primary health care service system, how to build the long-term care insurance system for the elderly insured groups and so on. Therefore, based on the theory of public goods, welfare economics, social equity and equalization of services, this paper makes a comparative study on the reform of medical insurance for urban and rural residents in Dongying, through literature analysis. Through field investigation, induction and deduction, and other research methods, this paper analyzes and studies in depth the present situation, problems and countermeasures of the basic medical insurance for urban and rural residents in Dongying, with a view to enriching the overall development of basic medical insurance for urban and rural residents in China. The relevant theories of reform and development have made positive contributions to the further development of residents' medical insurance in other areas, including Dongying City. The first chapter is the introduction, the second chapter mainly introduces the definition and theoretical basis of the urban and rural residents' medical insurance, the third chapter is the content and the way of the reform of the overall urban and rural residents' medical insurance in Dongying. The fourth chapter mainly explores the problems existing in the development of medical insurance for urban and rural residents in Dongying City and analyzes the reasons for its emergence. The fifth chapter is for the experience of advanced areas. Chapter six puts forward personal suggestions on the reform and perfection of medical insurance for urban and rural residents in Dongying.
【学位授予单位】:新疆大学
【学位级别】:硕士
【学位授予年份】:2017
【分类号】:F842.684

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