我国医疗保险基金财务会计信息披露研究

发布时间：2018-12-17 00:30

【摘要】：医疗保险是为补偿参保者因疾病风险造成的经济损失而建立的一项社会保险制度，，医疗保险基金为保障参保者的基本医疗、由用人单位和个人缴费而筹集建立的专项基金。社会保险法规定：社会保险经办机构负责医疗保险基金的筹集、管理和支付，并要建立健全预决算制度、财务会计制度和内部审计制度；医疗保险经办机构应当定期向社会公布医疗保险基金情况、医疗保险基金的收入、支出、结余和收益情况；国务院财政部门、社会保险行政部门、审计机关对社会保障基金的收支、管理和投资运营情况实施监督。但在实际运行中，医疗保险基金的管理和运营过程中暴露出许多问题，如医疗保险基金被骗取、挤占和挪用，医疗保险基金信息披露不充分、运营信息不透明等，直接影响医疗保险制度改革的进度和社会的和谐稳定。本文先对福利经济学的平等与效率理论、委托代理理论和博弈理论进行分析，确立了文章的理论基础；其次采用问卷调查的方法分析了医疗保险基金财务会计信息披露的主体、目标、会计核算基础、信息质量特征等；同时采用博弈分析的方法确立了医疗保险经办机构和参保者、政府监管部门、民间监管机构和注册会计师纳什均衡的决策行为，在此基础上构建了以资产负债表、收支表和现金流量表为主体财务会计信息披露体系；最后提出建立多层次的财务会计信息披露体系、全方位的监管体系和完善医疗保险信息系统的政策建议。文章的创新之处主要有两点：一是在规范研究的同时辅以问卷调查，提高了规范研究的科学性和可靠性；二是构建了以医疗保险基金资产负债表、收支表和现金流量表为主的医疗保险基金财务会计信息披露体系。
[Abstract]:Medical insurance is a social insurance system established to compensate the insured for the economic loss caused by the disease risk. The medical insurance fund is a special fund raised by employers and individuals to protect the basic medical care of the insured. The Social Insurance Law stipulates that the social insurance agencies are responsible for the collection, management and payment of medical insurance funds, and shall establish and improve the system of pre-accounting, financial accounting and internal audit; The medical insurance agency shall regularly announce to the public the status of the medical insurance fund, the income, expenditure, balance and income of the medical insurance fund; The financial department of the State Council, the administrative department of social insurance and the auditing institution shall exercise supervision over the income and expenditure, administration and investment operation of the social security fund. However, in the actual operation, many problems have been exposed in the management and operation of the medical insurance fund, such as the medical insurance fund being defrauded, embezzled and misappropriated, the information disclosure of the medical insurance fund is not sufficient, the operation information is not transparent, and so on. Directly affect the progress of medical insurance system reform and social harmony and stability. This paper first analyzes the equality and efficiency theory of welfare economics, principal-agent theory and game theory, and establishes the theoretical basis of the article; Secondly, the main body, target, accounting basis and information quality characteristics of financial accounting information disclosure of medical insurance fund are analyzed by questionnaire. At the same time, the game analysis method is used to establish the balanced decision-making behavior of medical insurance agencies and insurance providers, government regulators, private regulators and certified public accountants. On this basis, the balance sheet is constructed. Income and expenditure statement and cash flow statement are the main financial accounting information disclosure system; Finally, it puts forward the establishment of a multi-level financial and accounting information disclosure system, a comprehensive regulatory system and policy recommendations to improve the medical insurance information system. There are two main innovations in this paper: one is to improve the scientific nature and reliability of normative research by means of questionnaire survey in addition to normative research; Secondly, the financial and accounting information disclosure system of medical insurance fund is constructed, which is mainly composed of balance sheet, income and expenditure statement and cash flow statement.
【学位授予单位】：湖南大学
【学位级别】：硕士
【学位授予年份】：2013
【分类号】：F840.4

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