城乡居民大病保险制度的脱贫效应及模式研究

发布时间：2018-03-30 06:57

本文选题：城乡居民大病保险　切入点：大病保险模式　出处：《南京大学》2017年硕士论文

【摘要】：重大疾病所产生的高额的医疗费用,对于无保障或者保障水平不足的居民来说,会导致灾难性的后果,即"因病致贫、因病返贫"。我国现行的城乡居民基本医保制度,保障水平相对较低,未能有效缓解"因病致贫"问题,对于城乡居民来说,大病所产生的高额医疗费用,可谓灾难性的医疗支出,亟需更为合理有效的制度保障。基于此,国家于2012年出台了《关于开展城乡居民大病保险工作的指导意见》,各地由此开始试点实施大病保险制度。本文从大病致贫的角度出发,采取了理论与实证相结合的方法,分析了疾病与贫困之间的关系,研究了城乡居民基本医保和大病保险制度的"缓贫、脱贫"效应,发现疾病(尤其是重大疾病)所产生的高额医疗费用,会对个体和家庭产生严重的负面影响,如无合理的应对机制和制度安排,甚至会使个体和家庭陷入持续性、代际性的贫困。我国的城乡居民基本医保制度解决"因病致贫、返贫"问题效果欠佳,大病保险制度的实行则较为有效地解决了"因病致贫"问题,太仓、湛江、青海三种大病保险模式,都取得了不错的成效,可供不同社会经济发展水平地区借鉴。我国城乡居民大病保险制度实施以来,取得了非常显著的效果,保障效应持续放大,"因病致贫"问题得到了较为有效的缓解。本文基于实证研究和对我国大病保险实施的总体情况进行分析,发现我国大病保险制度效果虽然显著,但也存在一些问题,本文认为,应在"精准扶贫"大背景下,健全完善我国大病保险制度,继续提高保障水平、合理设定报销起付线和封顶线、精准定位保障对象、提高统筹层次、简化完善报销流程、加大宣传力度,发挥大病保险制度对城乡居民"因病致贫"问题的"脱贫效应",实现制度目标。
[Abstract]:The high cost of medical treatment caused by major diseases will lead to disastrous consequences for the residents who have no security or inadequate level of protection, that is, "poor because of illness, return to poverty because of illness".The current basic medical insurance system for urban and rural residents in China has a relatively low level of security and has not effectively alleviated the problem of "poverty caused by illness". For urban and rural residents, the high medical expenses caused by serious illness can be described as catastrophic medical expenses.More reasonable and effective system guarantee is urgently needed.Based on this, in 2012, the state issued the "guidelines on the development of urban and rural residents' serious illness insurance", and all localities began to pilot implement the serious illness insurance system.From the point of view of causing poverty by serious illness, this paper analyzes the relationship between disease and poverty by combining theory and practice, and studies the effects of basic medical insurance and insurance system on serious illness in urban and rural areas.Finding that high medical costs associated with diseases, especially major diseases, can have serious negative effects on individuals and families, such as the absence of reasonable coping mechanisms and institutional arrangements, and even perpetuate individuals and families,Intergenerational povertyThe basic medical insurance system for urban and rural residents in China solves the problem of "poverty caused by illness, returning to poverty", and the implementation of the insurance system for serious illness has solved the problem of "poverty caused by illness" more effectively. Three major illness insurance modes, Taicang, Zhanjiang and Qinghai, have been implemented.Both have achieved good results and can be used for reference in areas with different levels of social and economic development.Since the implementation of the insurance system for serious illness of urban and rural residents in China, it has achieved very remarkable results, the effect of protection has been continuously amplified, and the problem of "poverty caused by illness" has been more effectively alleviated.Based on the empirical study and the analysis of the general situation of the implementation of the major illness insurance in China, this paper finds that although the effect of the insurance system of our country is remarkable, there are still some problems.Perfect and perfect our country's serious illness insurance system, continue to improve the level of protection, rationally set the starting line and ceiling line for reimbursement, accurately locate the object of protection, raise the overall planning level, simplify and perfect the reimbursement process, and increase propaganda,Give full play to the "poverty relief" effect of the serious illness insurance system on urban and rural residents'"poverty caused by illness", and realize the system goal.
【学位授予单位】：南京大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R197.1;F842.684

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