临汾市贫困人口医疗救助问题研究

发布时间：2018-02-26 22:09

本文关键词： 贫困人口医疗救助社会保障　出处：《山西财经大学》2017年硕士论文　论文类型：学位论文

【摘要】：近年伴随居民就医难、看病贵问题的愈演愈烈,外加医疗保险制度运行的道德风险与逆向选择行为,临汾市经济发展水平的下行,低收入群体规模进一步加大,亟需对其开展医疗保障工作以维护广大居民尤其是贫困人口的基本医疗权益。医疗救助作为医疗保障领域的兜底性制度,也是我国一项基础的社会救助工作,其建立与完善有利于缩小不同收入水平的居民在生活水平、医疗福利上的差距,体现发展为了人民的要求,为城乡医疗救助对象的身体健康提供制度上的保障。本文对近年城乡医疗救助政策进行了梳理,就缓解贫困居民看病难、针对其开展医疗救助的文献进行了研究。并通过与临汾民政部门、最低生活保障中心的合作,整理了临汾医疗救助的文件与数据,分析了医疗救助的实际效果,并借鉴了贴合临汾实际的国内外地区的救助发展经验。从医疗救助的供给方、需求方的角度反映了存在的问题主要是:医疗救助制度落实不到位、救助标准缺乏科学性;申请医疗救助的手续繁琐;医疗资源配置失衡,救助资金投入动力不足,资金利用率偏低;尚未精准识别存在医疗救助需求的贫困对象,存在“应救未救”现象;“一站式”结算服务尚不成熟,引发过度医疗消费,救助工作的监管仍不到位。造成临汾医疗救助制度发展不甚理想的原因是多方位的,主要有城乡医疗救助资源不足、救助理念滞后、政府主体作用式微、主管部门职能缺位、非政府部门参与受限等。结合对制度利益相关者的访谈,根据产生问题的制约因素提出的对策主要是:进一步完善城乡医疗救助制度,提高统筹层次,明确界定受助对象的资格条件,合理制定救助标准;鼓励慈善机构和企业积极参与救助,利用私立医疗机构床位空置率高的资源;政府充分发挥主体作用,加快对医疗机构公益化运营的引导,培养专业的救助服务人员,规范对医疗救助供需双方的监管;做好相关社会政策之间与医疗救助的衔接,促使一站式结算规范运营;加快形成医前救助、预防保健的发展型救助理念,开展医疗救助领域的公私合作。鉴于医疗救助是完善多层次医疗保障制度的需要,应不断将政府、社会的工作重心转移到此项民生工程上,以真正解决贫困人口看病难的问题,使穷人能够病有所医。
[Abstract]:In recent years, with the difficulty of medical treatment for residents, the growing problem of expensive medical treatment, and the moral hazard and adverse selection behavior in the operation of medical insurance system, the level of economic development in Linfen City has declined, and the scale of low-income groups has further increased. It is urgent to carry out medical security work to safeguard the basic medical rights and interests of the majority of residents, especially the poor. Medical assistance, as a bottomless system in the field of medical security, is also a basic social assistance work in China. Its establishment and improvement will help to narrow the gap between the living standards and medical benefits of residents with different income levels, and reflect the requirements of development for the people. This paper reviews the urban and rural medical assistance policies in recent years, and aims to alleviate the difficulties for poor residents to see a doctor. Through the cooperation with Linfen Civil Affairs Department and minimum living Security Center, the paper collates the documents and data of medical aid in Linfen, and analyzes the actual effect of medical aid. From the point of view of the supply side of medical aid, the demand-side reflects the existing problems: the implementation of medical aid system is not in place, and the aid standard is not scientific; The procedures for applying for medical assistance are cumbersome; the allocation of medical resources is out of balance; there is insufficient power to invest aid funds, and the utilization rate of funds is on the low side; the poor objects in need of medical assistance have not been accurately identified. There is the phenomenon of "should be saved and not saved", the "one-stop" settlement service is still immature, causing excessive medical consumption, and the supervision of relief work is still not in place. The reasons for the unsatisfactory development of the medical aid system in Linfen are multi-faceted. There are not enough medical aid resources in urban and rural areas, the concept of aid is lagging behind, the main role of the government is declining, the function of the competent department is absent, the participation of the non-governmental sector is restricted, etc. In combination with interviews with institutional stakeholders, According to the restrictive factors of the problems, the countermeasures are as follows: further perfecting the medical aid system in urban and rural areas, raising the overall planning level, clearly defining the eligibility conditions of the recipients, and rationally formulating the relief standards; To encourage charitable organizations and enterprises to take an active part in the rescue and to make use of the resources with high vacancy rates of beds in private medical institutions; the government should give full play to its main role, speed up the guidance to the public welfare operations of medical institutions, and train professional rescue service personnel. Standardizing the supervision of both sides of medical aid supply and demand; making a good connection between relevant social policies and medical assistance, promoting one-stop settlement standard operation; speeding up the formation of pre-medical assistance, preventive health care development relief concept, In view of the need to improve the multi-level medical security system, we should constantly shift the focus of the work of the government and society to this livelihood project in order to really solve the problem of the poor people's seeing a doctor. Make it possible for the poor to get sick.
【学位授予单位】：山西财经大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：D632.1;R197.1

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