本文關(guān)鍵詞： 衛(wèi)生正義 公共服務(wù)產(chǎn)品均等化 基本醫(yī)療保險制度 俱樂部壁壘 公益外溢　出處：《蘇州大學(xué)學(xué)報(哲學(xué)社會科學(xué)版)》2013年02期 　論文類型：期刊論文

【摘要】：在"以人為本"的科學(xué)發(fā)展觀指導(dǎo)下,根據(jù)世界衛(wèi)生組織"人人享有公平的健康保障"的衛(wèi)生正義原則,我國在著力打破以身份、戶籍和地區(qū)為特征的歷史形成的城鄉(xiāng)二元、地區(qū)分割的醫(yī)療保障體系,推進公共服務(wù)產(chǎn)品均等化,推進建立全國統(tǒng)一的居民基本醫(yī)療保險體系。然而,這一建設(shè)遭遇到俱樂部壁壘的嚴(yán)重阻礙。長期以來,由于區(qū)域間、城鄉(xiāng)間、職業(yè)間經(jīng)濟發(fā)展水平和收入分配水平的嚴(yán)重差別,財稅"分灶吃飯"的體制,造成了公共產(chǎn)品的俱樂部化。地方政府、單位、行業(yè)都在建立根據(jù)自己財力承受能力,確定本位利益最大化的基本醫(yī)療保險體系,因而形成了在俱樂部內(nèi)部的外部性,在俱樂部外部的內(nèi)部性,形成俱樂部之間難以互通的森嚴(yán)壁壘。以發(fā)達地區(qū)壁壘為例,一旦需要開放俱樂部,使公益外溢,那么就必然面臨承擔(dān)拯救全國流動人口的"耗散難題"。解決俱樂部壁壘難題,是科學(xué)推進我國基本醫(yī)療保險制度健康有序發(fā)展的關(guān)鍵。
[Abstract]:Under the guidance of "people-oriented" view of scientific development, and according to the principle of health justice of the World Health Organization "everyone has fair health security", our country is trying to break the duality of urban and rural areas formed by the history of identity, household registration and region. The regionalization of the medical security system, the promotion of equalization of public service products, and the establishment of a unified national basic medical insurance system for residents. However, this construction has encountered serious obstacles from the club barrier. For a long time, because of the inter-regional, The serious differences between the level of economic development and income distribution between urban and rural areas and between occupations, and the system of fiscal and taxation "eating according to stoves" have resulted in the clubbing of public goods. Local governments, units, and industries are all building up their financial capacity according to their own means. The basic medical insurance system, which determines the maximization of standard benefits, forms the externality within the club, the internality outside the club, and the severe barriers which are difficult to communicate between clubs. Take the developed region as an example, Once it is necessary to open the club and make the public welfare overflow, it is inevitable to face the "dissipative problem" to save the floating population in the whole country. To solve the club barrier problem is the key to promote the healthy and orderly development of the basic medical insurance system in our country scientifically.
【作者單位】： 蘇州大學(xué)政治與公共管理學(xué)院;
【基金】：國家社會科學(xué)基金重點項目課題“推進新型農(nóng)村合作醫(yī)療制度改革”(項目編號:10AGL013)的階段性成果 江蘇高校優(yōu)勢學(xué)科建設(shè)工程“地方政府與社會管理”(編號:YX10200111)項目支持
【分類號】：F842.6

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本文編號：1534100