本文選題：基本醫(yī)療保障制度　切入點(diǎn)：政策并軌　出處：《東南大學(xué)》2017年碩士論文　論文類型：學(xué)位論文

【摘要】：十八大以來(lái),中央提出"健康中國(guó)"的發(fā)展理念,本研究在充分研究基本醫(yī)療保障制度運(yùn)行情況和倫理因素相關(guān)問(wèn)題文獻(xiàn)資料的基礎(chǔ)上,從倫理影響因素分析,以南京市浦口區(qū)開展的城鄉(xiāng)基本醫(yī)療保障制度并軌為案例,以理論和實(shí)踐緊密結(jié)合的研究方法,全面系統(tǒng)研究城鄉(xiāng)基本醫(yī)療保障制度并軌的倫理角度下的家庭、城鄉(xiāng)二元結(jié)構(gòu)傳統(tǒng)、公平性和平均主義、政府責(zé)任等倫理因素,以此創(chuàng)新和拓寬城鄉(xiāng)基本醫(yī)療保障制度并軌的內(nèi)涵,推進(jìn)城鄉(xiāng)基本醫(yī)療保障制度并軌政策的改革和建設(shè),為各地推進(jìn)城鄉(xiāng)基本醫(yī)療保障制度并軌提供建議。本研究共有六章。第一章為導(dǎo)論,對(duì)西方主要國(guó)家的基本醫(yī)療保障情況,國(guó)內(nèi)關(guān)于城鄉(xiāng)基本醫(yī)療保險(xiǎn)并軌的研究、公共管理倫理、生命倫理等文獻(xiàn)研究基本現(xiàn)狀。第二章主要結(jié)合南京市浦口區(qū)在2014年實(shí)施的城鎮(zhèn)居民醫(yī)保和新型農(nóng)村合作醫(yī)療制度并軌政策實(shí)施,采取的管理措施,運(yùn)用文獻(xiàn)研究法并對(duì)并軌后的制度實(shí)施、基金運(yùn)行情況進(jìn)行分析,采取走訪調(diào)查法對(duì)部分城鎮(zhèn)居民和農(nóng)村居民進(jìn)行調(diào)查研究,得出了并軌中存在的城鎮(zhèn)居民和農(nóng)村居民就醫(yī)習(xí)慣存在差異,農(nóng)村居民反哺城鎮(zhèn)居民的"窮幫富"現(xiàn)象,以及醫(yī)療總費(fèi)用上升過(guò)快,并軌后城鄉(xiāng)居民醫(yī)療保健需求得到釋放等主要問(wèn)題。第三章從傳統(tǒng)家庭成員間的分化進(jìn)行倫理因素分析出家庭成員間道德風(fēng)險(xiǎn)加劇等問(wèn)題。第四章從城鄉(xiāng)二元結(jié)構(gòu)因素分析對(duì)基本醫(yī)療保障制度并軌的影響,得出了城鄉(xiāng)一體化發(fā)展必須首先實(shí)現(xiàn)對(duì)人的價(jià)值的統(tǒng)一,以人為本的制定城鄉(xiāng)統(tǒng)一的醫(yī)療保障政策。第五章從公平性和平均主義的倫理因素解讀分析公平性與保大病之間的矛盾,"效率優(yōu)先兼顧公平"不適用于基本醫(yī)療保障,平均主義對(duì)困難人群的保障不足。第六章從政府責(zé)任分析必須建立服務(wù)型組織,防范道德風(fēng)險(xiǎn),建立醫(yī)療保障制度的動(dòng)態(tài)調(diào)節(jié)機(jī)制才能保證基本醫(yī)療保障制度的可持續(xù)發(fā)展。提出了以家庭為單元構(gòu)建各種醫(yī)療保障制度間的基金流通機(jī)制,使人人享有公平的基本醫(yī)療保障服務(wù)的建議。
[Abstract]:Since the 18 National Congress, the Central Committee has put forward the development concept of "healthy China". Based on the full study of the operation of the basic medical security system and the related issues related to ethical factors, this study analyzes the ethical influence factors. Taking the integration of urban and rural basic medical security systems in Pukou District of Nanjing as a case study, and using the research method of close combination of theory and practice, this paper comprehensively and systematically studies the families under the ethical perspective of the integration of urban and rural basic medical security systems. The traditional dual structure of urban and rural areas, fairness and equalitarianism, government responsibility and other ethical factors, so as to innovate and broaden the connotation of the basic medical security system in urban and rural areas, and promote the reform and construction of the policy of merging the basic medical security system in urban and rural areas. This study consists of six chapters. The first chapter is an introduction to the basic medical security situation in major western countries, and the domestic research on the integration of urban and rural basic medical insurance. The second chapter mainly combines the policy of urban residents medical insurance and the new rural cooperative medical system implemented in 2014 in Pukou District, Nanjing City, to take management measures. By using the method of literature research and the implementation of the system after the merger, the operation of the fund is analyzed, and some urban and rural residents are investigated and studied by the method of visiting and investigating. It is concluded that there are differences in the habit of seeking medical treatment between the urban residents and the rural residents, the phenomenon of rural residents feeding the poor and helping the rich to urban residents, and the increase of the total medical expenses are too fast. The third chapter analyzes the ethical factors of the division of traditional family members, and analyzes the problems of increasing moral hazard among family members. Chapter 4th combines urban and rural areas. The influence of structural factor analysis on the integration of basic medical security system, It is concluded that the development of urban-rural integration must first realize the unification of human values. The 5th chapter analyzes the contradiction between fairness and serious illness from the perspective of fairness and egalitarianism. "efficiency gives priority to fairness" does not apply to basic medical security. Egalitarianism does not protect the needy. Chapter 6th: from the analysis of government responsibility, we must establish service-oriented organizations to guard against moral hazard. Only by establishing the dynamic adjustment mechanism of the medical security system can the sustainable development of the basic medical security system be ensured. Proposals for equitable access to basic health care services for all
【學(xué)位授予單位】：東南大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2017
【分類號(hào)】：F842.684

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本文編號(hào)：1631611