公平视角下临汾市新农合运行中存在的问题研究

发布时间：2019-02-09 11:15

【摘要】：自2003年新型农村合作医疗制度在临汾市启动以来，便得到了广大农民的积极响应，参合比例逐步提高，覆盖面不断扩大。截至2012年，临汾市新型农村合作医疗参合率达到98.37%，在一定程度上缓解了农民“看病难、看病贵”的问题，促进了社会公平和正义的实现。在充分肯定已有成绩的同时，本文以公平为研究视角，提出并分析了临汾市新农合运行中存在的问题。通过系统调查临汾市新农合制度实施状况，总结出长期以来阻碍临汾市新农合制度公平目标实现的因素主要来自于新农合制度本身以及制度外部。其中制度本身的制约因素是制度设计、信息获取、医疗服务、基金筹集、受益补偿等方面公平缺失；制度外部的限制因素是农村相对于城镇而言经济条件差以及长期以来城乡二元结构体制下的城乡居民医疗保障水平差异较大。针对制度本身，提出持续发展新型农村合作医疗制度、加强宣传力度，，提高新农合信息知晓率、增加农村卫生资金投入、合理配置农村卫生资源、建立科学的基金筹集机制、健全基金监管机制等措施，以保证临汾市新农合制度公平目标的实现；针对制度外部的制约因素，提出贯彻党的十八大精神，加快农村经济发展及城乡一体化改革，促进城乡统筹的医疗保障制度的建立。相较于以往仅从新农合制度可持续性的角度进行研究，本文更注重研究该制度运行过程中的公平缺失问题，通过深入思考，提出了一系列合理化建议，不仅为完善临汾市新农合制度提供了理论依据，同时也为其他地区新农合制度的推行和借鉴提供了参考依据。
[Abstract]:Since the new rural cooperative medical system was launched in Linfen City in 2003, it has received a positive response from the majority of farmers. The proportion of participation and cooperation has gradually increased, and the coverage has been continuously expanded. Up to 2012, the participation rate of the new rural cooperative medical system in Linfen has reached 98.37. To a certain extent, it has alleviated the problem of "difficult to see a doctor, expensive to see a doctor", and promoted the realization of social equity and justice. While fully affirming the existing achievements, this paper puts forward and analyzes the problems existing in the operation of Linfen New Agricultural Cooperation from the perspective of fairness. Through a systematic investigation of the implementation of the new agricultural cooperation system in Linfen City, it is concluded that the factors hindering the realization of the fair goal of the new agricultural cooperation system in Linfen City for a long time mainly come from the new agricultural cooperation system itself and the external system. The system itself is restricted by the system design, information access, medical services, fund raising, benefit compensation and other aspects of the lack of fairness; The external limiting factors of the system are the poor economic conditions in rural areas relative to the cities and towns and the large differences in the level of medical security between urban and rural residents under the dual structure of urban and rural areas for a long time. In view of the system itself, this paper puts forward the sustainable development of the new rural cooperative medical system, the strengthening of propaganda, the improvement of the new rural cooperative medical information awareness rate, the increase of rural health fund input, the rational allocation of rural health resources, and the establishment of a scientific fund raising mechanism. Perfecting the fund supervision mechanism and other measures to ensure the realization of the fair goal of Linfen's new agricultural cooperation system; In view of the external restriction factors of the system, it is proposed to carry out the spirit of the 18th National Congress of the Party, speed up the rural economic development and the reform of the integration of urban and rural areas, and promote the establishment of the medical security system as a whole. Compared with the previous studies only from the perspective of sustainability of the NCMS system, this paper pays more attention to the lack of fairness in the operation of the NCMS system, and puts forward a series of rationalization suggestions through in-depth thinking. It not only provides a theoretical basis for perfecting the new agricultural cooperation system in Linfen City, but also provides a reference basis for the implementation and reference of the new agricultural cooperation system in other regions.
【学位授予单位】：山西财经大学
【学位级别】：硕士
【学位授予年份】：2013
【分类号】：F323.89;F842.684;R197.1

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