新型农村合作医疗保险制度问题研究

发布时间：2018-08-23 15:20

【摘要】：随着中国城镇化战略的深入推进,如何保障农民享有基本的医疗权利和维护他们的身体健康,这不仅关乎到经济发展过程中能否实现劳动力资源的充分供给,也直接决定着农村社会和谐稳定及能否全面建成小康社会这一重大目标。新型农村合作医疗保险制度在一定程度上缓解了农民面临的“就医难、就医贵”问题,并增强了他们参与医疗保险的意识,为农村地区经济和社会的稳定发展提供了制度保障。但是,农村地区经济社会环境的变迁以及新型农村合作医疗保险制度自身存在的诸多问题,都严重地制约了该制度的有效运行。现阶段,如何提高新型农村合作医疗保险制度的可操作性以及如何保障农民充分地享有医疗保障权利,已成为政府和学术界共同关注的重大现实问题。鉴于此,本文基于公共产品理论、社会保障理论、福利经济学理论和社会公平理论的主要观点,对新型农村合作医疗保险制度问题进行综合性研究。这不仅能够充实和丰富农村医疗保障研究的理论体系,同时也有助于推进我国农村医疗卫生事业的健康发展。本论文的研究目的在于推进新型农村合作医疗保险制度的可持续发展,并期望能够为政府有效地解决农村医疗问题提供决策参考。在界定基本概念和阐释相关理论的基础上,深入分析新型农村合作医疗保险制度的必要性,从该制度运行过程中总结其所呈现的主要特点,以运行模式、主要成就来体现该制度目前的发展情况。并且,指出新型农村合作医疗保险制度的现存问题主要包括政府职责问题、资金筹集问题、医疗体制问题和农民个体存在的问题。论文还阐述了英国、美国、德国、澳大利亚等典型国家的医疗保险模式,并归纳其成功经验和不足之处。针对这些问题,本文结合当前农民的就医实际和国外医疗保险制度的有效做法,提出了完善我国新型农村合作医疗保险制度的政策建议。首先,从顶层设计与制度细化相结合、城镇与农村医疗保险相结合、自愿性与强制性相结合、“保大病”与“保小病”相结合等方面提出新型农村合作医疗保险制度有效运行的应对思路。其次,从建立制度运行的竞争机制、推进制度运行的信息化建设、提升农村医疗保险服务水平、构建农村医疗保险评价体系等方面提出该制度有效运行的平台建设。最后,从政府应提供多维度的支持、资金来源应多渠道地供给、建立层次化医疗机构网络、农民积极参与合作医疗保险等方面提出该制度有效运行的基本路径。
[Abstract]:With the further development of China's urbanization strategy, how to ensure farmers enjoy basic medical rights and maintain their physical health is not only related to the realization of adequate supply of labor resources in the process of economic development. It also directly determines the rural social harmony and stability and whether the overall establishment of a well-off society is a major goal. To a certain extent, the new rural cooperative medical insurance system alleviates the problem that farmers are faced with "difficult and expensive medical treatment", strengthens their consciousness of participating in medical insurance, and provides a system guarantee for the stable development of economy and society in rural areas. However, the changes of economic and social environment in rural areas and the problems existing in the new rural cooperative medical insurance system seriously restrict the effective operation of the system. At the present stage, how to improve the operability of the new rural cooperative medical insurance system and how to ensure the farmers to fully enjoy the right to medical security have become a major practical issue that the government and academia have paid attention to. In view of this, based on the main viewpoints of public product theory, social security theory, welfare economics theory and social equity theory, this paper makes a comprehensive study on the new rural cooperative medical insurance system. This not only enriches and enriches the theoretical system of rural medical security research, but also contributes to the healthy development of rural medical and health care in China. The purpose of this paper is to promote the sustainable development of the new rural cooperative medical insurance system and to provide a reference for the government to solve the rural medical problems effectively. On the basis of defining the basic concepts and explaining the relevant theories, the necessity of the new rural cooperative medical insurance system is analyzed in depth, and the main features of the new rural cooperative medical insurance system are summarized in the course of its operation. The main achievements reflect the current development of the system. Moreover, it points out that the existing problems of the new rural cooperative medical insurance system mainly include government responsibility, fund raising, medical system and individual farmers' problems. The paper also describes the typical health insurance models in Britain, the United States, Germany and Australia, and sums up their successful experiences and shortcomings. In view of these problems, this paper puts forward some policy suggestions to perfect the new rural cooperative medical insurance system in China, combining with the current medical practice of farmers and the effective practice of foreign medical insurance system. First of all, from the top level design and system refinement, the combination of urban and rural medical insurance, voluntary and mandatory combination, This paper puts forward the effective operation of the new rural cooperative medical insurance system from the aspects of "protecting serious illness" and "protecting minor illness". Secondly, this paper puts forward the platform construction of the effective operation of the system from the aspects of establishing the competition mechanism of the system operation, promoting the informatization construction of the system operation, improving the level of rural medical insurance service, and constructing the evaluation system of the rural medical insurance. Finally, the basic path for the effective operation of the system is put forward from the following aspects: the government should provide multi-dimensional support, the source of funds should be supplied through multiple channels, the network of hierarchical medical institutions should be established, and farmers should actively participate in cooperative medical insurance.
【学位授予单位】：天津商业大学
【学位级别】：硕士
【学位授予年份】：2016
【分类号】：F842.684;F323.89;R197.1

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