本文關鍵詞： 精準扶貧 大病保險 對策　出處：《廣西大學》2017年碩士論文　論文類型：學位論文

【摘要】：現(xiàn)階段我國正處于社會轉(zhuǎn)型期,社會成員獲得經(jīng)濟社會資源時的差異性導致部分經(jīng)濟困難人群的出現(xiàn),他們對疾病風險的承受能力弱,在遇到重特大疾病時的抵抗能力較普通人群低下,復原能力也較弱,從而導致災難性衛(wèi)生支出的發(fā)生。為提升他們抵御重大疾病經(jīng)濟風險的能力,國家六部委于2012年8月,聯(lián)合出臺了《關于開展城鄉(xiāng)居民大病保險工作的指導意見》,而各地區(qū)也根據(jù)指導意見的指示并結(jié)合自身的實際情況展開了試點工作。隨著城鄉(xiāng)居民大病保險制度的實施和不斷完善,貧困居民因病返貧的狀況得到明顯改善,這也證明了我國商業(yè)健康保險和社會基本醫(yī)療保險之間的有效配合取得了重大性的突破。早在2014年,將大病醫(yī)保與精準扶貧結(jié)合來解決因病致貧難題,讓保險助力精準扶貧的具體工作就已經(jīng)開展,如扶貧項目信用保證保險、政策性農(nóng)業(yè)保險以及本文研究的大病保險等,這標志著保險助力精準扶貧的框架已經(jīng)形成,并在不斷嘗試推行和完善之中。精準扶貧工作與大病保險制度的有效結(jié)合,是一項利國利民的好政策:利國,大病保險的健康持續(xù)運行能夠改善貧困居民因病返貧的現(xiàn)象,推動我國全面構(gòu)建小康社會的進程以及提升我國的國際競爭力;利民,這是政策結(jié)合的最終目的,從根本上解決我國貧困居民的就醫(yī)問題,并進一步改善其生活狀況。所以保險業(yè)在精準扶貧工作推進的過程中發(fā)揮著重要作用。本論文主要分為五個章節(jié)。第一章為緒論,介紹了該選題的大背景,如研究方向、意義和方法等;第二章闡述了精準扶貧、大病保險的相關概念,精準扶貧工作機制如何運轉(zhuǎn),及建立城鄉(xiāng)居民大病保險制度的必要性分析,為理論研究奠定基礎;第三章主要介紹了我國扶貧開發(fā)工作從改革開放到新階段的發(fā)展歷程及現(xiàn)狀,還有我國大病保險的發(fā)展歷程、現(xiàn)狀分析及各地區(qū)的試點開展狀況;第四章針對目前我國試點中仍存在的問題,分別從基金效率、籌資渠道、費率厘定、醫(yī)療風險管控和職責界限等五個方面進行深入分析;第五章就是針對試點中存在的這些問題,結(jié)合精準扶貧政策,提出有益的對策及建議。
[Abstract]:At this stage, our country is in the social transition period, the difference of social members in obtaining economic and social resources leads to the emergence of some people with economic difficulties, their ability to bear the risk of disease is weak. The resistance and resilience of the general population are lower than those of the general population in the case of severe and severe diseases, which leads to catastrophic health expenditure in order to enhance their ability to resist the economic risk of major diseases. In August 2012, the State's six ministries and commissions jointly issued the "guidelines on the Development of serious illness Insurance for Urban and Rural residents". According to the guidance of the guidelines and in accordance with their own actual situation, the pilot work has been carried out. With the implementation and continuous improvement of the urban and rural residents' serious illness insurance system. The situation of poor residents returning to poverty has been obviously improved, which also proves that the effective cooperation between commercial health insurance and social basic medical insurance has made a significant breakthrough. As early as 2014. The combination of medical insurance for serious illness and precision poverty alleviation to solve the problem of poverty caused by illness, so that the specific work of helping the poor with precision insurance has been carried out, such as poverty alleviation project credit guarantee insurance. The policy-oriented agricultural insurance and the serious illness insurance studied in this paper, which indicates that the insurance helps the precision of poverty reduction framework has been formed. And continue to try to promote and improve. Precision poverty relief work and the effective combination of serious illness insurance system is a good policy for the benefit of the country and the people: benefit the country. The healthy and sustainable operation of the serious illness insurance can improve the phenomenon of poor residents returning to poverty because of illness, promote the process of building a well-off society in an all-round way and promote the international competitiveness of our country. Benefit to the people, this is the ultimate goal of policy combination, fundamentally solve the problem of poor residents of our country to seek medical treatment. And further improve its living conditions. Therefore, the insurance industry in the process of precision poverty alleviation work plays an important role. This paper is divided into five chapters. The first chapter is the introduction, introduced the background of this topic. Such as research direction, significance and methods; The second chapter expounds the related concepts of precision poverty alleviation and serious illness insurance, how to operate the precision poverty alleviation working mechanism, and the necessity analysis of establishing the urban and rural residents' serious illness insurance system, which lays a foundation for the theoretical research. The third chapter mainly introduces the development of poverty alleviation and development in China from the reform and opening up to the new stage, as well as the development process of China's major illness insurance, the current situation analysis and the status of the pilot projects in various regions. Chapter 4th, aiming at the problems that still exist in the pilot project in our country, analyzes the fund efficiency, the financing channel, the rate determination, the medical risk management and control and the duty limit respectively. Chapter 5th is aimed at these problems in the pilot project, combining with the policy of precision poverty alleviation, and puts forward some useful countermeasures and suggestions.
【學位授予單位】：廣西大學
【學位級別】：碩士
【學位授予年份】：2017
【分類號】：R197.1;F842.684

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