我国职工基本医疗保险法律制度的完善

发布时间：2018-05-09 04:28

本文选题：职工基本医疗保险 + 强制性参保　；参考：《东北财经大学》2016年硕士论文

【摘要】：当前,我国正处于建设"全民医保"和完善中国特色医疗保险体系的大背景下,本文将生存权保障理念、社会连带思想和社会平等思想作为社会保障法立法宗旨,针对我国医疗保险法律制度存在的问题,从法学的角度进行了探讨,并以此作为完善我国职工基本医疗保险法律制度的设计思路。全文共为四个部分,分别为职工基本医疗保险法律制度概述、职工基本医疗保险法律制度的主要内容及存在的问题、发达国家(地区)医疗保险制度模式及借鉴与职工基本医疗保险法律制度的完善。四个部分依次引出,循序渐进。在写作思路上遵循:介绍制度、发现问题、分析问题与解决问题的原则。第一部分介绍了职工基本医疗保险法律制度的相关概念、种类与特征,介绍了职工基本医疗保险制度与相关制度的区别,总结了职工基本医疗保险法律制度的作用,为本文探讨问题提供一个清晰的概念基础。第二部分介绍了职工基本医疗保险法律制度的主要内容,从历史的角度对我国职工基本医疗保险法律制度进行了分析,并对现阶段我国职工基本医疗保险所发挥的作用予以肯定。同时,剖析了现行制度存在的主要问题,如职工基本医疗保险实际参保率不理想、过度医疗现象普遍加重了医疗保险统筹基金负担以及职工基本呢医疗保险实际统筹层次偏低等问题,并且指出以上主要问题所带来的弊端。以此,为下文所提出的完善措施提供材料。第三部分讨论了域外主要医疗保险的制度模式,主要对德国、我国香港地区、英国与加拿大等医疗保险制度进行了简要的介绍,明确其中特征,比如德国医疗保险制度的主要特征在于将健康保险全民覆盖、我国香港通过政府经营公立医疗机构对其实施监管、英国实施国家卫生服务保障制度实现医疗资源配置的优化以及加拿大通过延伸医疗保险制度有效节约财政等。由此,将其中最鲜明之处予以分析,并根据我国现阶段实际情况借鉴其成功经验。第四部分通过第三部分域外医疗保险制度中的成功经验进行借鉴,旨在将该成功经验与我国实际情况相结合,解决第二部分提出的我国职工基本医疗保险现阶段存在的问题。同时,该部分提出完善我国职工基本医疗保险制度应当遵循的原则与具体措施,在理论与实践相结合,最终完善我国职工基本医疗保险制度。关于职工基本医疗保险制度,由于其涉及社会学、法学、经济学等许多人文社会科学领域,而目前对该制度的研究多停留于非法学领域,对于制度本身的讨论相对狭窄。因此,本文选择将职工基本医疗保险法律制度作为研究课题,能够从法学角度提出有针对性的完善原则与操作建议,具有一定的理论与实践价值。同时,我国职工基本医疗保险制度的完善路径某种程度可以为其他相关制度的完善提供借鉴,比如医疗保险制度范畴中的城镇居民基本医疗保险制度与新型农村合作医疗保险制度的完善。因为,职工基本医疗保险法律制度同城镇居民基本医疗保险法律制度与新型农村合作医疗保险法律制度相比较,虽然存在诸多差异,但是也存在诸多相同之处。综上,以法学思维分析我国职工基本医疗保险法律制度,针对其中存在的问题提出解决方案,不论是对于完善我国职工基本医疗保险法律制度本身还是其他相关法律制度都具有深刻意义。
[Abstract]:At present, under the background of building the "health insurance for all" and improving the medical insurance system with Chinese characteristics, this article discusses the concept of the protection of the right to existence, the thought of social connection and the thought of social equality as the legislative purpose of the social security law, and discusses the problems in the legal system of medical insurance in our country and discusses it from the angle of law. In order to improve the design ideas of the legal system of basic medical insurance for staff and workers in China, the full text is four parts, which are the outline of the legal system of basic medical insurance for workers and workers, the main contents and existing problems of the legal system of basic medical insurance for workers and workers, the model of the medical insurance system in the developed countries (regions) and the basic medical insurance law of the workers and workers. The improvement of the law system. The four parts are successively elicited, followed by step by step. In the writing train of thought, we follow the principles of introducing the system, finding the problems, analyzing the problems and solving the problems. The first part introduces the related concepts, types and characteristics of the legal system of basic medical insurance for workers and workers, and introduces the differences between the basic medical insurance system and the related system of the workers and workers. This paper summarizes the role of the legal system of basic medical insurance for workers and workers, and provides a clear conceptual basis for the discussion of the problems in this article. The second part introduces the main contents of the legal system of basic medical insurance for workers and workers, analyzes the legal system of basic medical insurance for workers and workers in China from a historical point of view, and gives a basic medical treatment for the workers in our country at the present stage. At the same time, the main problems of the current system are analyzed, such as the fact that the actual insurance rate of the basic medical insurance of the workers is not ideal, the overburden of the medical insurance overall fund and the low level of the basic medical insurance of the staff and workers are generally aggravated, and the main questions above are pointed out. The third part discussed the system model of the major medical insurance in the outside world, mainly introduced the medical insurance system in Germany, Hongkong, Britain and Canada, and made clear the characteristics, such as the main characteristics of the German medical insurance system. The health insurance is covered by the whole people. In Hongkong, the government manages public medical institutions through the government, the UK implements the national health service guarantee system to optimize the allocation of medical resources and the effective economy of Canada through the extended medical insurance system. The fourth part uses the successful experience of the third part of the extraterritorial medical insurance system for reference. The purpose is to combine the successful experience with the actual situation of our country and solve the existing problems of the basic medical insurance in the second part of our country. At the same time, this part puts forward to perfect me. The basic medical insurance system that the basic medical insurance system of the workers and workers should follow should be combined with the theory and practice to perfect the basic medical insurance system of the staff and workers in our country. In the field of non jurisprudence, the discussion of the system itself is relatively narrow. Therefore, this paper chooses the legal system of basic medical insurance for workers as a research topic, and can put forward pertinent principles and operational suggestions from the angle of law. It has a certain theoretical and practical value. Some extent can provide reference for the improvement of other related systems, such as the basic medical insurance system of urban residents and the improvement of the new rural cooperative medical insurance system in the category of medical insurance. Compared with the legal system of treatment and insurance, although there are many differences, there are many similarities. In conclusion, the legal system of basic medical insurance for workers and workers in China is analyzed by law thinking, and the solutions are put forward for the problems existing in it, whether it is to improve the legal system of basic medical insurance in our country or other relevant laws. The law system has profound significance.

【学位授予单位】：东北财经大学
【学位级别】：硕士
【学位授予年份】：2016
【分类号】：D922.182.3

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