地方政府城乡居民大病保险政策比较及其优化研究

发布时间：2019-08-07 07:37

【摘要】：大病保险政策是我国医疗保障政策的一部分。通过31个省份城乡居民大病保险政策比较发现:从政策的共同性来看,政策在明确目标任务与参保范围、资金来源与标准、保障水平、规范大病保险承办服务等四个方面做了相关规定;从政策的差异性性来看,主要体现为:政策颁布机构大部分是省政府办公厅、多数省份政策颁布时间早于国家时间、基金筹集主要采取固定额度模式和比例出资模式、具体的起付线和封顶线在多数省份没有规定、统筹层次上大多数采取市级统筹、报销比例方面近期多数省份规定不低于50%。大病保险进一步的优惠对策是:统一筹资标准,提高筹资水平;拓宽筹资渠道,建立多元化的资金筹资渠道;制定多层次政策起付标准;合理确定大病保险制度的最优保障水平;提高统筹层次和不设封顶线。
[Abstract]:The policy of serious illness insurance is a part of the medical security policy of our country. Through the comparison of the policy of serious illness insurance for urban and rural residents in 31 provinces, it is found that from the point of view of the commonality of the policy, the policy has made relevant provisions in four aspects: defining the target task and the scope of participation, the source and standard of funds, the level of protection, and standardizing the undertaking service of serious illness insurance. From the perspective of policy differences, it is mainly reflected in: most of the policy promulgation institutions are the general offices of the provincial government, most provincial policies are promulgated before the national time, fund raising mainly adopts fixed quota model and proportional capital contribution model, the specific starting line and capping line are not stipulated in most provinces, most of the overall planning level adopts municipal overall planning, and most provinces have recently stipulated that the reimbursement ratio is not less than 50%. The further preferential countermeasures of serious illness insurance are as follows: unifying the financing standard and improving the financing level; widening the financing channel and establishing the diversified fund financing channel; formulating the multi-level policy starting and paying standard; reasonably determining the optimal guarantee level of the serious illness insurance system; improving the overall planning level and not setting the top line.
【作者单位】：西南财经大学公共管理学院;广西师范大学法学院;
【基金】：国家社科基金项目“农村公共服务供给的‘碎片化’及其治理研究”(14BGL150) 广西文科中心“人文强桂”优青特色研究团队项目(YQTD2015002) 广西高校“马克思主义理论与区域实践协调创新中心”(桂教科研[2013]10号) 广西哲学社会科学2017年项目(17CGL001) 广西地方法治与地方治理研究中心课题(GXDFFZ201601) 广西师范大学博士科研启动项目[2016](26)阶段性成果
【分类号】：F842.684

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