建立和完善上海外来灵活就业人员医疗保险制度研究

发布时间：2018-12-11 10:54

【摘要】：经济体制改革和产业结构的调整使上海就业结构呈现多元化发展，灵活就业已成为一种重要的就业形式。上海外来灵活就业人员数量已逾200万，这一群体在参加社会医疗保险时，由于其收入较低、工作流动大等特点导致参保和转移接续困难，医保供需矛盾凸显。解决好这一群体的基本医保需求，关系到社会公平与效率，有利于上海社会医疗保险制度的进一步完善。上海市已先后出台一系列办法保障自由职业者、个体经济组织业主以及外来从业人员的医疗需求，但是现行的政策还未能很好覆盖上海外来灵活就业人员。论文在深刻把握我国经济社会发展水平基础上，结合时代背景，对上海社会医疗保险改革进行政策效应分析，肯定其成绩的同时也发现其需要进一步完善。本文对上海市外来灵活就业人员医疗保险进行抽样调查，发现其参保率和参保意愿均较低的现象，运用Spss、Excel等工具进行数据分析，发现上海现行社会医疗保险制度并不非常适合外来灵活就业人员，其参保机制、缴费机制与管理工作有待完善。为深入探究外来灵活就业人员医保供需现状，采用logistic多元回归方法分析了上海外来灵活就业人员医疗保险需求影响因素和上海市政府的医疗保险供给能力。在此基础上构建上海外来灵活就业人员医疗保险模式，采用MonteCarlo法对上海外来灵活就业人员关注的大病医疗保险进行制度设计，确定其缴费层次，并进行可行性分析。最终提出建立和完善上海外来灵活就业人员医疗保险制度的建议，包括制度运行环境优化和筹资渠道拓展等几个方面。论文在广泛搜集国内外灵活就业人员医疗保障文献的基础上，针对上海地区进行实地调研分析，，选题紧随新医改深化大背景，切入准确。采用定性研究与定量研究相结合，国内分析与国际比较相统一的方式，用Monte Carlo法对上海外来灵活就业人员的大病医疗进行方案设计并仿真预测，有较强的可行性，希望为上海市外来灵活就业人员的医疗保险制度提供切实可行的政策建议。
[Abstract]:The reform of economic system and the adjustment of industrial structure make the employment structure of Shanghai diversified and flexible employment has become an important form of employment. The number of migrant flexible employment personnel in Shanghai has exceeded 2 million. The contradiction between supply and demand of medical insurance is prominent because of the characteristics of low income and large work flow, which leads to the difficulty of joining insurance and transferring, and the contradiction between supply and demand of medical insurance. Solving the basic medical insurance needs of this group is related to social equity and efficiency, and is conducive to the further improvement of the social medical insurance system in Shanghai. Shanghai has introduced a series of measures to protect the medical needs of freelancers, proprietors of individual economic organizations and foreign employees, but the current policies have not covered the flexible employment of foreign workers in Shanghai. On the basis of deeply grasping the level of economic and social development in our country and combining with the background of the times, this paper analyzes the policy effect of the reform of social medical insurance in Shanghai, affirms its achievements and finds that it needs further improvement. This paper makes a sampling survey on the medical insurance of migrant workers with flexible employment in Shanghai, and finds out that the rate of participation and willingness to participate in insurance are both low. The data are analyzed by means of Spss,Excel and other tools. It is found that the current social medical insurance system in Shanghai is not very suitable for foreign flexible employment, and its insurance mechanism, payment mechanism and management need to be improved. In order to probe into the current situation of medical insurance supply and demand of foreign flexible employment personnel, the factors affecting the demand for medical insurance of foreign flexible employment personnel in Shanghai and the medical insurance supply capacity of Shanghai municipal government were analyzed by using logistic multiple regression method. On the basis of this, this paper constructs the medical insurance model of foreign flexible employment personnel in Shanghai, designs the medical insurance system of serious illness concerned by foreign flexible employment personnel in Shanghai by using MonteCarlo method, determines the level of payment, and analyzes the feasibility of the insurance system. Finally, some suggestions are put forward to establish and perfect the medical insurance system for migrant flexible employment personnel in Shanghai, including the optimization of the operating environment of the system and the expansion of funding channels. Based on the extensive collection of domestic and foreign medical security documents for flexible employment personnel, the paper carries out field investigation and analysis for Shanghai area, and the topic follows the deepening background of the new medical reform and cuts into the accuracy. Using the combination of qualitative and quantitative research, domestic analysis and international comparison, the Monte Carlo method is used to design and simulate the scheme of the medical treatment of Shanghai migrant workers with flexible employment, which has strong feasibility. Hope to provide practical policy advice for the medical insurance system of foreign flexible employment personnel in Shanghai.
【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】：2013
【分类号】：F842.684;F249.27

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