發(fā)布時(shí)間：2018-01-10 03:08

  本文關(guān)鍵詞：綿陽市整合城鄉(xiāng)居民基本醫(yī)療保險(xiǎn)制度的研究　出處：《西南科技大學(xué)》2017年碩士論文　論文類型：學(xué)位論文

  更多相關(guān)文章： 城鄉(xiāng)居民 整合 基本醫(yī)療保險(xiǎn)

【摘要】：我國已經(jīng)建成了以城鎮(zhèn)職工基本醫(yī)療保險(xiǎn)制度、新型農(nóng)村合作醫(yī)療、城鎮(zhèn)居民基本醫(yī)療制度和城鄉(xiāng)醫(yī)療救助制度為主體的具有中國特色的基本醫(yī)療保障體系,覆蓋人數(shù)超過了13億人口,全民醫(yī)保體系已基本形成。然而隨著社會(huì)的深入發(fā)展,這種城鄉(xiāng)二元制戶籍下形成的城鄉(xiāng)二元化的醫(yī)療保障制度的弊端也日益顯現(xiàn)出來,主要表現(xiàn)在缺乏社會(huì)公平性、不利于人力資源的流動(dòng)、不利于醫(yī)療保險(xiǎn)制度的可持續(xù)發(fā)展,同時(shí)造成了財(cái)政部門進(jìn)行的重復(fù)財(cái)政補(bǔ)貼、城鄉(xiāng)居民的重復(fù)參保現(xiàn)象、相關(guān)部門重復(fù)的建立信息系統(tǒng)和經(jīng)辦機(jī)構(gòu)等系列問題。解決這一系列問題最有效的方式是實(shí)現(xiàn)我國基本醫(yī)療保險(xiǎn)的城鄉(xiāng)統(tǒng)籌。早些年,國務(wù)院曾提出過“三保合一”即城鎮(zhèn)職工基本醫(yī)療保險(xiǎn)制度、新型農(nóng)村合作醫(yī)療、城鎮(zhèn)居民基本醫(yī)療保險(xiǎn)制度三制度合一的目標(biāo),由于現(xiàn)目前三種制度在繳費(fèi)標(biāo)準(zhǔn)和待遇享受方面還存在著較大的差異,“三保合一”并不能馬上實(shí)現(xiàn),而新型農(nóng)村合作醫(yī)療和城鎮(zhèn)居民基本醫(yī)療保險(xiǎn)的“兩保合一”卻是具備了足夠的社會(huì)經(jīng)濟(jì)條件,他們具有相似的參保原則、籌資標(biāo)準(zhǔn)和籌資模式。本文采用了比較分析法和案例分析法,首先對整合城鄉(xiāng)居民基本醫(yī)療保險(xiǎn)的研究背景研究意義、文獻(xiàn)綜述和相關(guān)理論基礎(chǔ)進(jìn)行了介紹,其次對我國現(xiàn)行的基本醫(yī)療保險(xiǎn)發(fā)展歷程現(xiàn)狀結(jié)構(gòu)進(jìn)行了梳理并提出了其存在的問題和對社會(huì)發(fā)展的影響,再次分析了整合城鄉(xiāng)居民基本醫(yī)療保險(xiǎn)的可行性和意義,最后以綿陽市整合城鄉(xiāng)居民基本醫(yī)療保險(xiǎn)為例,從綿陽市城鄉(xiāng)居民基本醫(yī)療保險(xiǎn)的參保對象、籌資機(jī)制、籌資水平、待遇和補(bǔ)償水平、基金和組織管理這五個(gè)方面分別進(jìn)行兩種制度的對比分析,分析整合存在的問題,同時(shí)借鑒國內(nèi)整合城鄉(xiāng)居民基本醫(yī)療保險(xiǎn)的試點(diǎn)的先驅(qū)城市成都市和常熟市的經(jīng)驗(yàn),主要從統(tǒng)一覆蓋人群、統(tǒng)一籌資方式、統(tǒng)一籌資標(biāo)準(zhǔn)、統(tǒng)一補(bǔ)償機(jī)制、基金風(fēng)險(xiǎn)控制和統(tǒng)一管理體制六個(gè)方面為綿陽市整合城鄉(xiāng)居民基本醫(yī)療保險(xiǎn)工作提出主要思路和建議。
[Abstract]:China has built a basic medical security system with Chinese characteristics, which is based on the basic medical insurance system for urban workers, the new rural cooperative medical care system, the basic medical care system for urban and rural residents and the medical assistance system for urban and rural residents. With more than 1.3 billion people covered, the universal health care system has been basically formed. However, with the further development of society. The malpractice of the urban-rural dual medical security system formed under the urban-rural dual household registration system is also increasingly apparent, which is mainly reflected in the lack of social equity, which is not conducive to the flow of human resources. It is not conducive to the sustainable development of the medical insurance system, at the same time caused the repeated financial subsidies carried out by the financial sector, urban and rural residents of repeated participation in the phenomenon. Relevant departments repeatedly establish information systems and agencies and other issues. The most effective way to solve this series of problems is to realize the urban and rural planning of basic medical insurance in China. The State Council has put forward the goal of "three guarantees in one", that is, the basic medical insurance system for urban workers, the new rural cooperative medical insurance system and the basic medical insurance system for urban residents. As there are still big differences between the three systems in payment standard and treatment enjoyment, "three guarantees in one" can not be realized immediately. However, the new rural cooperative medical insurance and the basic medical insurance of urban residents have sufficient social and economic conditions, and they have similar principles of participating in insurance. This paper uses comparative analysis and case analysis. Firstly, it introduces the research background significance, literature review and related theoretical basis of integrating basic medical insurance of urban and rural residents. Secondly, the current development process of basic medical insurance in China has been combed and the existing problems and the impact on social development have been put forward. The feasibility and significance of integrating the basic medical insurance of urban and rural residents is analyzed again. Finally, taking Mianyang City as an example to integrate the basic medical insurance of urban and rural residents, from the basic medical insurance of Mianyang urban and rural residents to participate in the object of medical insurance. Financing mechanism, funding level, treatment and compensation level, fund and organization management of these five aspects of comparative analysis of the two systems, analysis of the integration of the existing problems. At the same time draw lessons from the experience of Chengdu and Changshu, the pilot cities of integrating the basic medical insurance of urban and rural residents in China, mainly from the unified coverage of the population, unified funding methods, unified funding standards, unified compensation mechanism. Six aspects of fund risk control and unified management system for Mianyang City to integrate the basic medical insurance of urban and rural residents put forward the main ideas and suggestions.
【學(xué)位授予單位】：西南科技大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2017
【分類號】：R197.1;F842.684

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