城镇职工基本医疗保险分散大病风险研究——基于广东典型地区的分析

发布时间：2018-07-21 14:20

【摘要】：选取广东省三个代表性地区的大规模医疗保险数据,对职工医保分散大病风险的效果进行了定量分析和模拟测算。从总体上看,参保人的医疗负担还比较重;职工医保在缓解灾难性支出方面作用明显,但整体效果有限。在40%的门槛下,欠发达地区灾难性支出发生率达到29.3%,发达地区也达到了8.5%。相对弱势的中老年群体和低收入群体是灾难性支出发生率最高的群体,但并未受到职工医保的充分照顾。相反,20-39岁的年青群体和高收入阶层成为相对受益最大的群体。从保障水平调整机制、补充医疗保障体系以及医疗救助与职工医保的衔接等三个方面提出了政策建议。
[Abstract]:Based on the large scale medical insurance data in three representative areas of Guangdong province, the effects of health insurance on dispersing the risk of serious illness are quantitatively analyzed and simulated. On the whole, the insured's medical burden is heavy; the effect of employee medical insurance is obvious in alleviating catastrophic expenditure, but the overall effect is limited. At the threshold of 40%, the incidence of catastrophic expenditure in the less developed areas reached 29.3% and 8.5% in the developed regions. The relatively weak middle-aged and low-income groups are the ones with the highest incidence of catastrophic expenditure but are not adequately taken care of by health insurance. In contrast, the 20-39-year-old and high-income groups were the relatively most beneficial groups. The policy suggestions are put forward from three aspects: the adjustment mechanism of security level, the supplementary medical security system and the link between medical assistance and medical insurance for employees.
【作者单位】：广东财经大学金融学院;
【基金】：国家社会科学基金重大项目:《新时期中国民生保障体系建设研究》(10&ZD038)
【分类号】：F842.6

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