中国社会医疗保险制度改革的历程及其收入分配效果测度

发布时间：2018-04-17 11:08

本文选题：社会医疗保险制度 + 改革历程　；参考：《湘潭大学》2014年硕士论文

【摘要】：改革开放以来，我国各方面事业都得到发展。经济发展、居民生活水平提高，但是问题也接踵而来，中国的收入分配不公的问题也在逐渐突显。我国政府为改善收入分配不平等的问题采取了多种政策措施，，比如建立社会医疗保障体系。为实现收入水平低的人群也能得到有效的公共医疗服务，缓解由疾病造成的收入分配不平等问题，我国政府不断推动社会医疗保险制度改革。基于这个背景，测度政府实行的社会医疗保险制度的收入分配效果是本文关注的焦点。本文以福利经济学理论为基础，从社会医疗保险制度的医疗服务提供、医疗服务的利用以及筹资情况三个方面来分析。以医疗改革大事件为线索，将我国的社会医疗保险制度改革分为三个大的方面：第一阶段，20世纪50年代初期-20世纪80年代初期为计划市场时期；第二阶段，20世纪80年代初期-1993年为市场经济过渡时期；第三阶段，1994年-2012年为市场经济完善时期。使用中国营养与健康调查数据CHNS，从宏观层面计算综合的社会医疗保险制度的收入再分配效果，来深层次分析研究社会医疗保险制度缓解我国社会的收入不平等情况的效果。为了更加全面的分析，本文又测度了不同医疗社会保障制度的收入再分配效果，探讨了社会医疗保险制度的三种制度何种可以更好的起到缩小社会的收入差距，改善社会的收入分配效果。研究结果表明：（1）居民的医疗费用支付会使得社会的基尼系数上升，加剧社会的收入不平等，反映了居民的医疗费用支付的确是扩大社会收入分配差距的因素之一。中国社会医疗保险制度实施补偿后社会的基尼系数会下降，表明中国社会医疗保险制度从社会全局的角度改善了我国的收入分配效果。（2）居民群体的收入越低，每人医疗费用支付占每人收入的比率就越高，低收入群体比高收入群体的医疗负担相对更重些。（3）城镇每人医疗费用支付占每人收入的比率都远远低于农村，城镇相对农村的医疗支付费用负担会更轻些。
[Abstract]:Since the reform and opening up, all aspects of our cause have been developed.With the development of economy and the improvement of living standard, China's income inequality is becoming more and more serious.In order to improve the inequality of income distribution, our government has adopted various policy measures, such as the establishment of social medical security system.In order to realize that the people with low income can also get effective public medical services and alleviate the inequality of income distribution caused by diseases, our government has continuously promoted the reform of social medical insurance system.Based on this background, it is the focus of this paper to measure the income distribution effect of the social medical insurance system implemented by the government.Based on the theory of welfare economics, this paper analyzes the provision of medical service, the utilization of medical service and the financing of social medical insurance system.Taking the medical reform as the clue, this paper divides the reform of social medical insurance system into three aspects: the first stage is from the early 1950s to the early 1980s as the planning market period;The second stage is the transitional period of market economy from the early 1980s to 1993, and the third stage, from 1994 to 2012, is the perfect period of market economy.Using CHNSdata of China Nutrition and Health Survey, the income redistribution effect of the comprehensive social medical insurance system is calculated from the macro level, and the effect of the social medical insurance system on alleviating the income inequality in our country is deeply analyzed and studied.In order to make a more comprehensive analysis, this paper also measures the income redistribution effect of different medical social security systems, and discusses how the three systems of social medical insurance system can play a better role in narrowing the social income gap.Improve social income distribution.The results show that the payment of medical expenses will increase the Gini coefficient of the society and aggravate the income inequality of the society, which reflects that the payment of medical expenses is one of the factors to widen the gap of social income distribution.The Gini coefficient of China's social health insurance system will decline after the implementation of the compensation, which indicates that the Chinese social medical insurance system has improved the income distribution effect of our country from the perspective of the overall social situation.) the lower the income of the residents, the lower the income of the residents.The ratio of medical expenses to income per person is higher, and the lower income groups have a relatively heavier medical burden than the higher income groups) the proportion of medical expenses paid per person per person in urban areas is much lower than that in rural areas.Cities and towns will have a lighter burden of paying for medical care than in the countryside.
【学位授予单位】：湘潭大学
【学位级别】：硕士
【学位授予年份】：2014
【分类号】：F124.7;F842.684;R197.1

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