城镇职工基本医疗保险基金结余合理化水平研究

发布时间：2018-02-21 06:05

本文关键词： 城镇职工基本医疗保险基金结余合理化水平个人账户　出处：《安徽财经大学》2015年硕士论文　论文类型：学位论文

【摘要】：1998年城镇职工基本医疗保险制度建立以来,历年城镇职工基本医疗保险基金收入和支出的非均衡增长(基金收入明显快于基金支出)导致基金当年结余和累计结余规模不断扩大。截至2013年底,我国城镇职工基本医疗保险基金当年结余达到1447亿元,累计结余也高达8130亿元。换句话说,即使在没有发生当年基金收入以及来年的基金支出保持不变的的前提下,单靠累计结余的基金就可以保障14个月的基金支出。巨额的城镇职工医保基金结余,成为了中国社会保障领域的热议话题之一。如果基金能够保持适度的结余水平,就可以防范未来医疗费用支付带来的风险,可是基金的过多结余却可能损害参保者利益。现阶段我国医保基金的高结余会带来哪些影响以及如何去实现合理化的城镇职工基本医疗保险基金结余水平,这是我们目前需要深入研究的问题。本文从影响城镇职工基本医疗保险基金的因素分析出发,深入探究导致职工医疗保险基金高结余的根源,最后针对产生基金高结余的根源,相应地提出如何实现合理化的城镇职工基本医疗保险基金结余水平政策建议。本文总共分为六个部分。第一章导论。本章主要内容包括本文的选题背景及意义、文献综述(国内和国外文献综述)、研究方法和结构以及可能的创新点与不足之处。第二章主要对城镇职工基本医疗保险基金的现状进行梳理以及指出城镇职工基本医疗保险基金在运行过程中所存在的问题并且应该遵循的一般规律。接着在对我国三大基本医疗保险基金进行了比较的同时,也从区域出发对最近几年各省市的城镇职工基本医疗保险基金进行比较分析。第三章首先在对进行城镇职工基本医疗保险基金结余的深度分析之后,接着在假设前提下对未来城镇职工基本医疗保险基金的结余进行预测从而实现城镇职工基本医疗保险基金结余合理化水平。第四章用实证研究方法对影响城镇职工基本医疗保险基金的相关因素进行分析,最后深入阐述导致城镇职工基本医疗保险基金结余过多的原因。第五章选取一个典型的城市作为研究的案例,介绍了该市城镇职工基本医疗保险制度的演变以及城镇职工基本医疗保险基金的运行现状。第六章为本文的总结章节。主要阐述了在遵循基金“以收定支、收支平衡、略有结余”原则的前提下,如何实现合理化的城镇职工基本医疗保险基金结余水平的具体对策建议。
[Abstract]:The basic medical insurance system for urban workers in 1998 over the years since the establishment of non balanced urban workers' basic medical insurance fund income and expenditure growth (fund income is significantly faster than the fund spending) lead to fund balances for the current year and the cumulative balance scale is continually expanding. At the end of 2013, the basic medical insurance fund for urban workers in China and then the balance reached 144 billion 700 million yuan, the cumulative balance as high as 813 billion yuan. In other words, even in the absence of the current year and next year the income of the fund fund expenditures remain unchanged under the cumulative balance of funds alone can guarantee 14 months of fund expenditure. Huge urban workers medical insurance fund balance, has become a hot topic in the field of social security China if one. The fund can maintain an appropriate balance level, can prevent the risk of future payment of medical expenses, but too much can balance fund Can damage the interests of the insured. High balances at the present stage of China's medical insurance fund will be what impact and how to realize the rationalization of urban workers' basic medical insurance fund balance level, this is we need to study the problem. In this paper, from the influence factors of the basic medical insurance fund for urban workers based on the analysis, in-depth exploration leads to medical workers the insurance fund balances high root, according to the origin of fund balances, puts forward how to realize the urban workers' basic medical insurance fund balance policy rationalization proposal.
This paper is divided into six parts. The first chapter is introduction. The main contents of this chapter include the background and significance of this topic, literature review (domestic and foreign literature review), research methods and structure, and possible innovations and shortcomings.
The second chapter is mainly on the basic medical insurance fund to sort out the general law and points out that the basic medical insurance fund for urban workers in the process of operating problems and should follow. Then in the three of China's basic medical insurance fund are compared at the same time, from the starting region in recent years each and the basic medical insurance fund were compared and analyzed.
The third chapter in depth to analyze the urban workers basic medical insurance fund balance, then the future urban workers' basic medical insurance fund balance in the assumption that in order to achieve the balance of urban employee basic medical insurance fund reasonable level prediction.
The fourth chapter analyzes the related factors that affect the basic medical insurance fund of urban employees by using the empirical research method, and finally elaborates the reasons leading to the excessive surplus of basic medical insurance fund for urban employees.
The fifth chapter selects a typical city as a case study. It introduces the evolution of basic medical insurance system for urban workers and the operation status of basic medical insurance fund for urban workers.
The sixth chapter is the summary section of this paper. It mainly expounds how to achieve the rationalization of the balance of basic medical insurance fund of urban workers under the premise of the principle of "fixed income, balance of payments and a little surplus".

【学位授予单位】：安徽财经大学
【学位级别】：硕士
【学位授予年份】：2015
【分类号】：F842.6

【参考文献】