中日医疗保险制度的经济效应比较研究
发布时间：2018-09-15 19:36
【摘要】：医疗保险制度是指某个国家依照保险合同规定,为解决国民预防治疗疾病问题而筹措、分配并使用医疗保险基金的制度。医疗保险制度是一种比较进步的社会保障制度,是人类文明进步与社会积极发展的必然结果,对于维持社会安定、确保社会经济的健康可持续发展有着不可替代的作用。同时,医疗保险制度的改革一直是中国医药卫生体制改革的重要部分,更是“三医联动”所不可或缺的一环,其未来的改革与发展方向关系到“新医改”的成败与否。日本不仅是亚洲第一个实行医疗保险的国家,而且是世界范围内建立医疗保险制度较早的国家之一。其医疗保险制度的管理模式早期由德国引进,在第二次世界大战之后又借鉴了美国的一些做法,逐渐制订实施了一系列的卫生立法及相关的法律法规,最终形成了独具日本特色的医疗保险制度。这一制度的建立对于维护日本经济的持续、稳定发展以及保障日本社会的安定、有序运行发挥了举足轻重的作用。当下,中国医改进入深水区,医疗保险制度的改革同样面临着诸多挑战。而日本医疗保险制度在发展的过程中,曾经遇到的或正在积极应对的很多难题与中国的问题具有相似性,而且很多的改革措施已经取得了显著成效。同时,日本与中国同属儒家文化圈,都是具有悠久农业社会历史的国家,两者在文化渊源与经济社会演化路径上具有相通性和相似性。因此,这就使得借鉴日本医疗保险制度的改革相关方法与措施,促进中国医疗保险制度的发展进步成为可能。本文通过医疗保险制度的经济效应作为研究重点,在横向比较历史沿革和纵向对比具体项目的基础上,采用“推拉效应”模型和医疗保险制度居民消费效应模型对中日医疗保险制度的经济效应进行实证分析。在其基础上得出结论并尝试对中国医疗保险制度的改革与完善提出政策建议。本文除绪论外,主要分为五章,具体内容安排如下：第一章介绍了相关概念的界定及相关基础理论。本章节着重对研究中需要使用的几个重要概念进行了具体界定,同时对公共产品及市场失灵理论、逆向选择与道德风险和消费理论等相关基础理论进行论述。第二章通过发展历程的角度对中日医疗保险制度进行纵向比较。本章节从历史沿革、运行现状和演化路径三个角度,从纵向上对中日医疗保险制度进行比较,在概述两国医保制度发展进程的基础上,勾勒出各自医疗保险制度的整体框架结构,最后从制度演化路径的差异上发现中国的不足与日本的优势。第三章通过具体项目的角度对中日医疗保险制度进行横向比较。本章节为进一步对中日两国现行医保制度进行对比分析,特选取保险人、参保对象、筹资制度、支付制度和收支情况五个具体项目,通过不同项目指标和考察角度来对中日医疗保险制度进行横向上的比较研究。基于相同项目上的异同,发现和借鉴日本的特色与创新点,以改进中国的问题与不足。第四章这是本文的核心章节,即中日医疗保险制度经济效应的实证分析。考虑到作者本人的现实能力,本文的研究将主要专注于宏观层面的研究分析。在这里,为了便于进行研究和计算,本文将医疗保险制度的经济效应分为两个部分,即国民经济层面上的经济发展效应和居民个体层面上的居民消费效应。对于经济发展效应的研究分析,本文将采用“推拉效应”模型进行具体测算,具体指标主要包括：人均GDP和医疗保险基金支出,来考察医疗保险制度对于国民经济发展的影响。而对于居民消费效应的研究分析,本文将通过构建医疗保险制度模型来进行具体测算,具体指标主要包括：本国居民消费水平、本国医疗保险人均支出、本国居民的人均财富量和本国抚养比,来考察医疗保险制度对于居民消费水平的影响。通过在相关文献和官方网站上的公开数据,进行中日医疗保险制度经济效应的计算比较,并对中日两国的分析结果进行简要说明。第五章提出结论和相关建议。针对存在问题,根据测算数据,提出改革医疗保险支付制度、促进卫生资源合理配置、多种方式破除“以药养医”、激发调动医务人员积极性和加快完善配套制度改革等具体建议。
[Abstract]:Medical insurance system refers to a system in which a country raises funds for the prevention and treatment of diseases and distributes and uses medical insurance funds in accordance with the provisions of insurance contracts. At the same time, the reform of the medical insurance system has always been an important part of the reform of China's medical and health system, and also an indispensable part of the "three medical links". The future reform and development direction of the medical insurance system is related to the success or failure of the "new medical reform". Japan is not only Asia. It was the first country in the continent to implement medical insurance and one of the earliest countries in the world to establish a medical insurance system. The management model of its medical insurance system was introduced from Germany in the early days. After World War II, it drew lessons from some practices in the United States and gradually formulated and implemented a series of health legislation and related laws. The establishment of this system has played an important role in maintaining the sustained development of the Japanese economy, ensuring the stability and orderly operation of the Japanese society. In the course of the development of this medical insurance system, many problems that have been encountered or are being actively dealt with are similar to those in China, and many reform measures have achieved remarkable results. There are similarities and similarities in the path of economic and social evolution. Therefore, it is possible to learn from the relevant methods and measures of the reform of Japanese medical insurance system to promote the development and progress of China's medical insurance system. On the basis of specific items, this paper uses the "push-pull effect" model and the consumption effect model of medical insurance system to analyze the economic effects of Chinese and Japanese medical insurance system. The specific contents are as follows: Chapter 1 introduces the definition of relevant concepts and related basic theories. This chapter focuses on the specific definition of several important concepts to be used in the study. At the same time, it discusses the basic theories of public goods and market failure theory, adverse selection and moral hazard and consumption theory. This chapter compares the medical insurance system of China and Japan from three angles: historical evolution, operation status and evolution path, compares the medical insurance system of China and Japan vertically, and outlines the overall framework of the medical insurance system of the two countries on the basis of summarizing the development process of the medical insurance system. In the third chapter, the author compares the Chinese and Japanese medical insurance systems horizontally from the perspective of specific projects. This chapter makes a further comparative analysis of the current medical insurance systems in China and Japan, especially selects the insurers, the insured, the financing system, the payment system and the acceptance system. Based on the similarities and differences of the same items, we find and learn from the characteristics and innovations of Japan in order to improve China's problems and deficiencies. Chapter 4 is the core chapter of this paper, namely, the Sino-Japanese medical insurance system. Considering the author's practical ability, this paper will mainly focus on the macro-level research and analysis. Here, in order to facilitate research and calculation, this paper divides the economic effect of the medical insurance system into two parts, namely, the economic development effect on the national economic level and the residents'individual level. For the research and analysis of the economic development effect, this paper will use the "push-pull effect" model to calculate the specific indicators, including: per capita GDP and medical insurance fund expenditure, to examine the impact of the medical insurance system on the national economic development. This paper will build a model of medical insurance system to calculate the specific indicators, including: the level of domestic consumption, the per capita expenditure on medical insurance, the per capita wealth of domestic residents and the domestic dependency ratio, to examine the impact of the medical insurance system on the level of consumption of residents. The fifth chapter puts forward the conclusion and relevant suggestions. Aiming at the existing problems, according to the calculation data, the paper proposes to reform the medical insurance payment system, promote the rational allocation of health resources, and break the "medicine for medical care" in many ways. "To stimulate the enthusiasm of mobilizing medical personnel and accelerate the improvement of supporting system reform.
【学位授予单位】：辽宁大学
【学位级别】：硕士
【学位授予年份】：2016
【分类号】：F842.684;R197.1
本文编号：2244301
[Abstract]:Medical insurance system refers to a system in which a country raises funds for the prevention and treatment of diseases and distributes and uses medical insurance funds in accordance with the provisions of insurance contracts. At the same time, the reform of the medical insurance system has always been an important part of the reform of China's medical and health system, and also an indispensable part of the "three medical links". The future reform and development direction of the medical insurance system is related to the success or failure of the "new medical reform". Japan is not only Asia. It was the first country in the continent to implement medical insurance and one of the earliest countries in the world to establish a medical insurance system. The management model of its medical insurance system was introduced from Germany in the early days. After World War II, it drew lessons from some practices in the United States and gradually formulated and implemented a series of health legislation and related laws. The establishment of this system has played an important role in maintaining the sustained development of the Japanese economy, ensuring the stability and orderly operation of the Japanese society. In the course of the development of this medical insurance system, many problems that have been encountered or are being actively dealt with are similar to those in China, and many reform measures have achieved remarkable results. There are similarities and similarities in the path of economic and social evolution. Therefore, it is possible to learn from the relevant methods and measures of the reform of Japanese medical insurance system to promote the development and progress of China's medical insurance system. On the basis of specific items, this paper uses the "push-pull effect" model and the consumption effect model of medical insurance system to analyze the economic effects of Chinese and Japanese medical insurance system. The specific contents are as follows: Chapter 1 introduces the definition of relevant concepts and related basic theories. This chapter focuses on the specific definition of several important concepts to be used in the study. At the same time, it discusses the basic theories of public goods and market failure theory, adverse selection and moral hazard and consumption theory. This chapter compares the medical insurance system of China and Japan from three angles: historical evolution, operation status and evolution path, compares the medical insurance system of China and Japan vertically, and outlines the overall framework of the medical insurance system of the two countries on the basis of summarizing the development process of the medical insurance system. In the third chapter, the author compares the Chinese and Japanese medical insurance systems horizontally from the perspective of specific projects. This chapter makes a further comparative analysis of the current medical insurance systems in China and Japan, especially selects the insurers, the insured, the financing system, the payment system and the acceptance system. Based on the similarities and differences of the same items, we find and learn from the characteristics and innovations of Japan in order to improve China's problems and deficiencies. Chapter 4 is the core chapter of this paper, namely, the Sino-Japanese medical insurance system. Considering the author's practical ability, this paper will mainly focus on the macro-level research and analysis. Here, in order to facilitate research and calculation, this paper divides the economic effect of the medical insurance system into two parts, namely, the economic development effect on the national economic level and the residents'individual level. For the research and analysis of the economic development effect, this paper will use the "push-pull effect" model to calculate the specific indicators, including: per capita GDP and medical insurance fund expenditure, to examine the impact of the medical insurance system on the national economic development. This paper will build a model of medical insurance system to calculate the specific indicators, including: the level of domestic consumption, the per capita expenditure on medical insurance, the per capita wealth of domestic residents and the domestic dependency ratio, to examine the impact of the medical insurance system on the level of consumption of residents. The fifth chapter puts forward the conclusion and relevant suggestions. Aiming at the existing problems, according to the calculation data, the paper proposes to reform the medical insurance payment system, promote the rational allocation of health resources, and break the "medicine for medical care" in many ways. "To stimulate the enthusiasm of mobilizing medical personnel and accelerate the improvement of supporting system reform.
【学位授予单位】：辽宁大学
【学位级别】：硕士
【学位授予年份】：2016
【分类号】：F842.684;R197.1
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