本文選題：醫(yī)療保障　切入點：城鄉(xiāng)二元割裂　出處：《云南大學(xué)》2013年碩士論文　論文類型：學(xué)位論文

【摘要】：醫(yī)療保險制度改革的建立健全是一個世界性的難題,也是一項浩繁的系統(tǒng)工程,尤其是在中國這樣一個人口多、底子薄的大國。雖然現(xiàn)行的醫(yī)療保險制度開創(chuàng)了前無古人的事業(yè),但并不是我們的理想目標(biāo)。我國現(xiàn)行醫(yī)療保險制度以城鄉(xiāng)、地區(qū)、職業(yè)和人群為分割要素,造成醫(yī)療待遇水平差異很大的城鄉(xiāng)二元割裂格局,既違背公平和效率原則,也越來越不適應(yīng)我國經(jīng)濟(jì)社會的日益發(fā)展和市場經(jīng)濟(jì)對醫(yī)療保險制度的一元化需求。黨中央、國務(wù)院高度重視整合醫(yī)療保險制度這項工作,這項工作已勢在必行,可以在消除醫(yī)療保險的城鄉(xiāng)二元割裂格局的同時,以達(dá)到促進(jìn)實現(xiàn)城鄉(xiāng)統(tǒng)籌發(fā)展的目標(biāo)。在這樣的背景下,本文以公共產(chǎn)品理論、福利經(jīng)濟(jì)學(xué)及社會分層理論作為理論基礎(chǔ),以昆明市城鄉(xiāng)統(tǒng)籌醫(yī)療保障制度為研究目標(biāo),通過對現(xiàn)行制度差異性的比較分析,討論昆明市實施城鄉(xiāng)統(tǒng)籌醫(yī)療保險制度的必要性和可行性,并探討如何根據(jù)自身情況選擇一條適合自己的城鄉(xiāng)統(tǒng)籌醫(yī)療保險制度之路。力圖討論在城鄉(xiāng)統(tǒng)籌并最終實現(xiàn)城鄉(xiāng)一體化這個過程中,如何平衡城鄉(xiāng)統(tǒng)籌醫(yī)療保險制度與職工醫(yī)療保險制度兩者的關(guān)系,不是延續(xù)以往的“打補丁”式的制度設(shè)計方法,而是構(gòu)建出一個可持續(xù)性的制度運行框架,最大程度避免兩個制度之間形成的摩擦和各種障礙,盡可能既實現(xiàn)社會公平,又能最大程度提高公共管理效率。 全文共分7章,其基本框架如下： 第1章：緒論,從中國城鄉(xiāng)醫(yī)療保障制度“二元三分”格局的形成入手,介紹研究背景、研究意義、研究方法等； 第2章：理論基礎(chǔ)與文獻(xiàn)綜述。介紹了文章的理論基礎(chǔ)公共產(chǎn)品、福利經(jīng)濟(jì)學(xué)及社會分層理論,對幾組相關(guān)概念進(jìn)行界定,并對城鄉(xiāng)統(tǒng)籌基本醫(yī)療保障制度研究的相關(guān)文獻(xiàn)做了述評； 第3章：昆明市城鄉(xiāng)醫(yī)療保障制度的差異分析,梳理了昆明市醫(yī)療保險制度發(fā)展情況,同時對制度間差異進(jìn)行比較分析,認(rèn)為昆明市醫(yī)療保險事業(yè)取得成績的同時,也面臨著很多挑戰(zhàn)與問題； 第4章：國內(nèi)外城鄉(xiāng)統(tǒng)籌醫(yī)療保障制度的經(jīng)驗借鑒,通過對國內(nèi)外典型案例的分析,從中梳理了對昆明市實施城鄉(xiāng)居民基本醫(yī)療保險可借鑒的經(jīng)驗； 第5章：昆明市城鄉(xiāng)統(tǒng)籌基本醫(yī)療保障制度實施的必要性和可行性分析； 第6章：昆明市城鄉(xiāng)統(tǒng)籌基本醫(yī)療保障制度的框架設(shè)計；重點描述了籌資方案和補償方案的設(shè)計思路及確定方案。 第7章：結(jié)語及展望,總結(jié)了昆明市實施城鄉(xiāng)統(tǒng)籌醫(yī)療保障制度的現(xiàn)狀,同時展望了后續(xù)可供研究的問題。
[Abstract]:The establishment and improvement of the medical insurance system reform is a worldwide problem and a huge systematic project, especially in China with such a large population. Although the current medical insurance system has created an unprecedented cause, it is not our ideal goal. The current medical insurance system in our country is divided into urban and rural areas, regions, occupations and people. The dichotomy pattern between urban and rural areas, which leads to great differences in medical treatment level, is not only against the principles of fairness and efficiency, but also more and more unsuited to the growing economic and social development of our country and the unified demand of the market economy for the medical insurance system. The State Council attaches great importance to the work of integrating the medical insurance system, which is imperative. It can eliminate the urban-rural split pattern of medical insurance and at the same time achieve the goal of promoting the overall development of urban and rural areas. In this context, Based on the theory of public goods, welfare economics and social stratification theory, this paper takes the urban and rural medical security system of Kunming as the research goal, through the comparative analysis of the differences of the current system. The necessity and feasibility of implementing the urban and rural medical insurance system in Kunming are discussed. It also discusses how to choose a suitable way of urban-rural overall medical insurance system according to its own situation. It tries to discuss the process of urban-rural planning and finally realizing urban-rural integration. How to balance the relationship between urban and rural medical insurance system and employee medical insurance system is not a continuation of the previous "patching" system design method, but a sustainable framework of system operation. To the greatest extent, the friction and obstacles between the two systems can be avoided, and the social equity and the efficiency of public administration can be improved as much as possible. This paper is divided into seven chapters, its basic framework is as follows:. Chapter 1: introduction, starting from the formation of the "dual three-point" pattern of China's urban and rural medical security system, introduces the research background, research significance, research methods and so on. Chapter 2: theoretical basis and literature review. This paper introduces the theoretical basis of public goods, welfare economics and social stratification theory, and defines several related concepts. It also reviews the relevant documents of the study on the basic medical security system in urban and rural areas. Chapter 3: the analysis of the difference between urban and rural medical security system in Kunming, combing the development of medical insurance system in Kunming, at the same time, comparing the differences between the systems, and considering that Kunming medical insurance industry has made achievements at the same time, Also facing many challenges and problems; Chapter 4: the experience of urban and rural health insurance system at home and abroad, through the analysis of typical cases at home and abroad, combing the basic medical insurance for urban and rural residents in Kunming can learn from the experience; Chapter 5: the necessity and feasibility analysis of urban and rural basic medical security system in Kunming; Chapter 6: the frame design of the basic medical security system of urban and rural planning in Kunming, with emphasis on the design and determination of the financing scheme and the compensation scheme. Chapter 7: conclusion and prospect, summarizes the current situation of urban and rural medical security system in Kunming, and looks forward to the problems to be studied in the future.
【學(xué)位授予單位】：云南大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2013
【分類號】：F842.684;R197.1

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