【摘要】：改革和完善社會保障制度是新形勢下社會發(fā)展的客觀要求和必然趨勢，醫(yī)療保險是社會保障體系中的重要內容。近幾年來，醫(yī)療保險制度迅速發(fā)展的同時也帶來了一系列的問題，一方面醫(yī)療費用迅速增長，另一方面給付水平仍然較低，因此，如何合理的調整醫(yī)療保險的給付水平將是一個重要的研究課題。醫(yī)療保險是指以保險合同約定的醫(yī)療行為的發(fā)生為給付條件的，為被保險人在接受診療期間所發(fā)生的醫(yī)療費用提供保障的保險。社會醫(yī)療保險是國家通過立法形式強制實施的，當被保險人因疾病接受醫(yī)療服務時按照規(guī)定進行的一種經(jīng)濟補償制度。由于商業(yè)醫(yī)療保險在遼寧省實施的范圍有限，所以本文研究的為社會醫(yī)療保險。 遼寧省從2000年開始相繼建立了城鎮(zhèn)職工基本醫(yī)療保險醫(yī)療、新型農(nóng)村合作醫(yī)療保險、城鎮(zhèn)居民基本醫(yī)療保險制度，經(jīng)過近十年的發(fā)展，醫(yī)療保險制度取得了長足的進步。但在醫(yī)療保險的具體實施過中，保險給付水平低、基金收支不平衡、醫(yī)療保險的補償機制不完善等現(xiàn)象依然存在，特別是近幾年，醫(yī)療費用逐年增長，“以藥養(yǎng)醫(yī)”的局面仍然存在，老百姓“看病難、看病貴”的問題也并沒有得到解決，這些問題的發(fā)生嚴重制約著我省醫(yī)療保險制度的發(fā)展和完善。要想解決以上問題，首先要明確我省目前的醫(yī)療保險給付水平是多少，社會統(tǒng)籌和個人賬戶的金額能支付的比例是多少；其次要知道目前的這種給付水平與我們的籌資是否匹配；最后要有針對性的提出問題的建議。因此通過對遼寧省目前醫(yī)療保險給付水平的比較分析，找出我給付水平存在的問題，并如何在基金容許的范圍內適當提高給付水平，并將是本文需要著重解決的問題。 本文主要采用定性研究和定量研究相結合的方式，從遼寧省醫(yī)療保險給付水平的實際情況出發(fā)，對醫(yī)療保險制度進行簡單的總結和歸納，，采用定量的分析方法對遼寧省現(xiàn)有的醫(yī)療保險的給付水平進行測算，著重分析了在現(xiàn)有水平下所提供的醫(yī)療保險實際給付水平，并將其與籌資水平下應提供的給付水平進行比較，找出二者的差距。通過對世界上典型國家的醫(yī)療保險給付水平的比較和分析，結合遼寧省的實際情況，提出相應的對策及建議，進一步促進醫(yī)療保險的完善和發(fā)展。
[Abstract]:Reforming and perfecting the social security system is the objective requirement and inevitable trend of social development under the new situation. Medical insurance is an important content in the social security system. In recent years, the rapid development of the medical insurance system has also brought about a series of problems. On the one hand, the medical costs are increasing rapidly, on the other hand, the level of payment is still relatively low. How to adjust the payment level of medical insurance is an important research topic. Medical insurance refers to the insurance that takes the occurrence of medical behavior as the condition of payment and provides the insurance for the medical expenses incurred by the insured during the period of diagnosis and treatment. Social medical insurance is a kind of economic compensation system when the insured receives medical service because of illness. Because the scope of commercial medical insurance in Liaoning Province is limited, this paper studies social medical insurance. Since 2000, Liaoning Province has established the basic medical insurance system for urban workers, the new rural cooperative medical insurance system and the basic medical insurance system for urban residents. After nearly ten years of development, the medical insurance system has made great progress. However, in the specific implementation of medical insurance, the level of insurance payment is low, the fund income and expenditure are unbalanced, the compensation mechanism of medical insurance is not perfect and so on. Especially in recent years, the medical expenses have increased year by year. The situation of "raising medicine with medicine" still exists, and the common people's problem of "difficult to see a doctor, expensive to see a doctor" has not been solved, and the occurrence of these problems has seriously restricted the development and perfection of medical insurance system in our province. Want to solve above problem, want to clear our province current medical treatment insurance to pay level first, the amount that social overall planning and individual account can pay is what proportion; Second, we need to know whether the current payment level and our funding match, and finally to put forward targeted suggestions. Therefore, through the comparative analysis of the current level of medical insurance benefits in Liaoning Province, we can find out the problems existing in our payment level, and how to properly raise the level of payment within the scope allowed by the fund, which will be the problem this paper needs to focus on. This article mainly uses the qualitative research and the quantitative research the way, from Liaoning Province medical insurance payment level actual situation, carries on the simple summary and the induction to the medical insurance system, The quantitative analysis method is used to measure the payment level of the medical insurance in Liaoning Province, and the actual level of the medical insurance provided at the present level is emphatically analyzed. And compare it with the level of payment under the level of financing, and find out the gap between them. Through the comparison and analysis of the level of medical insurance payment in typical countries in the world, combined with the actual situation in Liaoning Province, the corresponding countermeasures and suggestions are put forward to further promote the improvement and development of medical insurance.
【學位授予單位】：遼寧大學
【學位級別】：碩士
【學位授予年份】：2013
【分類號】：F842.684

【參考文獻】

相關期刊論文 前10條

1 曹源;杜慶;;美國新醫(yī)改的實施情況及對我國的借鑒[J];當代經(jīng)濟;2011年17期

2 熊林平;夏登穩(wěn);丁陶;;城市居民醫(yī)療保險費用模擬分析[J];第二軍醫(yī)大學學報;2011年07期

3 武萍;洪霞;;新型農(nóng)村合作醫(yī)療籌資水平研究——以遼寧省為例的實證分析[J];農(nóng)村經(jīng)濟;2012年09期

4 陳德君,羅元文;日本醫(yī)療保險制度及其對我國的啟示[J];日本研究;2002年03期

5 畢金龍;;醫(yī)療保險費用支付方式的影響因素研究[J];人口與經(jīng)濟;2010年S1期

6 王桂勝;;中國社會醫(yī)療保險基金預測分析[J];首都經(jīng)濟貿(mào)易大學學報;2009年02期

7 顧海;魯翔;左楠;;英國醫(yī)保模式對我國醫(yī)保制度的啟示與借鑒[J];世界經(jīng)濟與政治論壇;2007年05期

8 徐偉;;國際經(jīng)驗對我國醫(yī)療保險費用控制機制的啟示[J];世界經(jīng)濟與政治論壇;2010年02期

9 馮國忠;朱亭酈;;美國醫(yī)療保險制度現(xiàn)狀、改革及給我們的啟示[J];上海醫(yī)藥;2006年07期

10 劉曉梅;楚廷勇;;日本社會醫(yī)療保險全覆蓋的經(jīng)驗——兼評我國的醫(yī)改方案[J];探索與爭鳴;2010年07期

相關碩士學位論文 前10條

1 庚辰;基于老年人口變化的基本醫(yī)療保險基金平衡研究[D];遼寧大學;2011年

2 王月嬌;遼寧省城鎮(zhèn)職工醫(yī)療保險費用控制研究[D];遼寧大學;2011年

3 伊洪麗;沈陽市醫(yī)療保險改革公平性評價及對策研究[D];東北大學;2005年

4 羅莉;關于我國城鎮(zhèn)醫(yī)療保險制度改革的探討[D];武漢大學;2005年

5 馬紅;遼寧省新型農(nóng)村合作醫(yī)療制度推進研究[D];大連理工大學;2009年

6 衣小玫;城鎮(zhèn)醫(yī)療保險模式研究[D];中國海洋大學;2009年

7 熊菲;日本醫(yī)療保險制度對我國的啟示[D];武漢科技大學;2009年

8 王利娟;農(nóng)村醫(yī)療保險研究[D];山東大學;2009年

9 袁萍;我國城鄉(xiāng)醫(yī)療保險制度比較及統(tǒng)籌機制研究[D];山東經(jīng)濟學院;2010年

10 郭雪嬌;山西省城鎮(zhèn)職工醫(yī)療保險支付研究[D];山西財經(jīng)大學;2010年

本文編號：2303337