政府购买大病保险服务的问题及对策研究

发布时间：2018-02-26 04:35

本文关键词： 大病保险服务政府购买问题与对策　出处：《山西大学》2016年硕士论文　论文类型：学位论文

【摘要】：2012年8月,国务院六部委(国家发改委、卫生部、财政部、人社部、民政部、保监会)联合发文《关于开展城乡居民大病保险工作的指导意见》,拉开了全国范围内政府购买城乡居民大病保险服务的序幕。它是政府购买公共服务在社会保障服务领域的有益探索,是运用保险机制转变政府职能、创新社会治理方式的有力举措。城乡居民大病保险政策施行三年来成效明显与问题突出的态势并存,总结现有经验,破解发展难题,服务于推进政策全面落实和丰富政府公共服务理论成为研究初衷。本文综合运用结构访谈、实地调研、文献分析、理论分析多种研究方法,以治理理论、民营化理论和合同管理为理论依据,通过聚焦政府购买大病保险服务的运行现状,分析了制度层面和操作层面存在的问题,最终从观念转变、机制完善、制度健全、能力提升四个方面为政府购买大病保险服务提出了相关的政策建议。本文由五部分构成,首先对政府购买大病保险服务的相关概念进行了界定。其次汇总了政府购买大病保险的基本情况,包括其缘起背景、政策要点、主要成效和意义,并重点进行了商业保险机构承办城乡居民大病保险的现实分析。接着遵循合同式管理逻辑动态分析了政府购买大病保险服务合同订立、合同履行、合同终止与纠纷处理各环节的突出问题及原因。最后,紧扣已有问题提出了切实转变观念,明晰政府职能;完善相关政策法规,持续优化运作机制;建立并推行严格的监督评估体系;提升政府、商业保险机构、公民参与能力这四方面协同互动的改善建议,最终推动政府职能转变及公共服务提供方式创新,作用于实现政府治理能力和治理体系的现代化。
[Abstract]:In August 2012, six ministries and commissions of the State Council (the National Development and Reform Commission, the Ministry of Health, the Ministry of Finance, the Ministry of Human and Social Affairs, the Ministry of Civil Affairs, The CIRC) jointly issued a "guiding opinion on carrying out the work of serious illness insurance for urban and rural residents", which opened the prelude that the government buys the insurance service for the serious illness of urban and rural residents nationwide. It is the prelude that the government buys the public service in the social security. Useful exploration in the field of services, It is a powerful measure to change the government's functions and innovate the way of social governance by using the insurance mechanism. In the three years since the implementation of the insurance policy for urban and rural residents with serious illness, the results have obviously coexisted with outstanding problems. We have summed up the existing experience and solved the difficult problems of development. It has become the original intention of the research to serve to promote the full implementation of the policy and enrich the theory of government public service. This paper makes comprehensive use of structural interviews, field research, literature analysis, theoretical analysis of a variety of research methods to governance theory, Based on the theory of privatization and contract management, this paper analyzes the problems existing in the system and operation by focusing on the current situation of the government's purchase of the insurance service for serious illness, and finally changes the concept, improves the mechanism, and improves the system. Four aspects of ability enhancement have put forward relevant policy recommendations for the government to purchase insurance services for serious illness. This paper consists of five parts. First of all, it defines the related concepts of the government's purchase of the serious illness insurance service. Secondly, it summarizes the basic situation of the government's purchase of the serious illness insurance, including its origin background, key policy points, main effects and significance. Then, according to the management logic of contract, the conclusion of the contract for the purchase of the serious illness insurance service by the government and the fulfillment of the contract are analyzed. The problems and reasons of the termination of contract and the settlement of disputes. Finally, it puts forward the idea of changing the concept, clarifying the functions of the government, perfecting the relevant policies and regulations, and continuously optimizing the operation mechanism. To establish and implement a strict supervision and evaluation system, to enhance the four aspects of government, commercial insurance institutions and citizen participation ability, and to promote the transformation of government functions and the innovation of public service delivery methods. Function in the realization of government governance capacity and governance system modernization.
【学位授予单位】：山西大学
【学位级别】：硕士
【学位授予年份】：2016
【分类号】：R197.1;F842.684

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