广东珠三角地区农村大病医疗保险问题研究

发布时间：2019-01-14 07:38

【摘要】：十八届三中全会以后,随着我国深化改革的全面启动,农村居民医保领域的深层次问题开始浮现出来,其中“看病贵、看病难、因病返贫、因病致贫”等影响农村居民生存质量和生活品质的大病医疗保险问题,正在受到越来越广泛的关注。大病医疗保险既是一项社会福利工作,也是重要的民生工程,其政策性很强,各地有不同的实施办法,由此形成大病医保的不同模式,并随时间的推移不断发生变化。虽然近年来试行的新农合在一定程度上减轻了农民的经济负担,使农民敢看病,但是对大农村大病患者来说,新农合制度还很难缓解患者的经济负担。要真正使新农合有效地解决农村大病患者的高额医疗费用,防止农村居民因病致贫、因病返贫,保证新农合的可持续发展,还有很长的道路需要走。本文以农村大病医疗统筹保险的相关理论为依据,通过对广东珠三角农村大病医保的调查研究,以期了解农村大病医疗统筹保险存在的问题并提出相应对策。作为我国改革开放的前沿地区之一,珠三角地区经过多年的医疗体制改革,其农村地区的医疗卫生事业有了长足的发展,有中国特色的农村医保制度体系建设,也取得了显著成就。与中国大多数地区一样,珠三角地区农村大病医疗保险是被结合在新农合的普通医保中的。与新农合的普通医保相比,由于大病医疗保险需要的资源更多、涉及的因素更复杂,所以珠三角地区新农合尽管有了长足的的发展,但大病医疗保险领域仍然有许多问题亟待解决,其中大病医疗保险发展水平滞后、大病医疗保险机制不完善、大病医疗保险资金不足等,是较为突出的问题。为了解决农村大病医疗保险发展中存在的一些问题,政府需要积极发挥组织引导作用,农民及农村集体需要积极参与,此外要探索运用市场机制,让包括保险公司在内的社会力量进入农村大病医疗保险领域,并致力于将农村大病医疗保险纳入法制化发展轨道。
[Abstract]:After the third Plenary session of the 18th CPC Central Committee, with the full start of the deepening reform in our country, the deep-seated problems in the field of medical insurance for rural residents began to emerge. Among them, "it is expensive to see a doctor, difficult to see a doctor, and to return to poverty because of illness." The medical insurance of serious illness, which affects the quality of life and quality of life of rural residents, is receiving more and more attention. The medical insurance of serious illness is not only a social welfare work, but also an important project of people's livelihood. Its policy is very strong, and there are different implementation methods in various places, thus forming different modes of medical insurance for serious illness, and changing constantly with the passage of time. Although the new rural cooperation tried in recent years has lightened the peasants' economic burden to a certain extent and made the peasants dare to see a doctor, it is difficult to alleviate the economic burden of the patients in the big rural areas by the new rural cooperative system. There is still a long way to go to ensure the sustainable development of NCMS in order to effectively solve the high medical expenses of rural patients, prevent rural residents from becoming poor because of illness, and ensure the sustainable development of NCMS. Based on the relevant theories of medical insurance for serious illness in rural areas, this paper makes an investigation and study on the medical insurance of serious illness in the Pearl River Delta of Guangdong Province, in order to understand the problems existing in the medical insurance of serious illness in rural areas and put forward the corresponding countermeasures. As one of the frontier areas of China's reform and opening up, the Pearl River Delta region, after many years of medical system reform, the medical and health services in rural areas have made great progress, and the rural medical insurance system with Chinese characteristics has been built. Remarkable achievements have also been made. As in most parts of China, the PRD's rural health insurance is integrated with NCMS's general health insurance. Compared with the general medical insurance system of the New Rural Cooperation (NCMS), because the medical insurance for serious illnesses requires more resources and involves more complicated factors, the NCMS in the Pearl River Delta region has made considerable progress despite its considerable development. However, there are still many problems to be solved in the field of medical insurance for serious illness, among which the development level of medical insurance for serious illness lags behind, the mechanism of medical insurance for serious illness is not perfect, and the fund for medical insurance for serious illness is insufficient. In order to solve some problems existing in the development of medical insurance for serious illness in rural areas, the government needs to give full play to the role of organization and guidance, farmers and rural collectives need to participate actively. In addition, it is necessary to explore the use of market mechanisms. Social forces, including insurance companies, should be allowed to enter the field of medical insurance for serious diseases in rural areas and devote themselves to bringing rural medical insurance into the legal development track.
【学位授予单位】：中南林业科技大学
【学位级别】：硕士
【学位授予年份】：2014
【分类号】：F842.684;F323.89;R197.1

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