本文選題：職工基本醫(yī)療保險 + 強(qiáng)制性參保��； 參考：《東北財(cái)經(jīng)大學(xué)》2016年碩士論文

【摘要】：當(dāng)前,我國正處于建設(shè)"全民醫(yī)保"和完善中國特色醫(yī)療保險體系的大背景下,本文將生存權(quán)保障理念、社會連帶思想和社會平等思想作為社會保障法立法宗旨,針對我國醫(yī)療保險法律制度存在的問題,從法學(xué)的角度進(jìn)行了探討,并以此作為完善我國職工基本醫(yī)療保險法律制度的設(shè)計(jì)思路。全文共為四個部分,分別為職工基本醫(yī)療保險法律制度概述、職工基本醫(yī)療保險法律制度的主要內(nèi)容及存在的問題、發(fā)達(dá)國家(地區(qū))醫(yī)療保險制度模式及借鑒與職工基本醫(yī)療保險法律制度的完善。四個部分依次引出,循序漸進(jìn)。在寫作思路上遵循:介紹制度、發(fā)現(xiàn)問題、分析問題與解決問題的原則。第一部分介紹了職工基本醫(yī)療保險法律制度的相關(guān)概念、種類與特征,介紹了職工基本醫(yī)療保險制度與相關(guān)制度的區(qū)別,總結(jié)了職工基本醫(yī)療保險法律制度的作用,為本文探討問題提供一個清晰的概念基礎(chǔ)。第二部分介紹了職工基本醫(yī)療保險法律制度的主要內(nèi)容,從歷史的角度對我國職工基本醫(yī)療保險法律制度進(jìn)行了分析,并對現(xiàn)階段我國職工基本醫(yī)療保險所發(fā)揮的作用予以肯定。同時,剖析了現(xiàn)行制度存在的主要問題,如職工基本醫(yī)療保險實(shí)際參保率不理想、過度醫(yī)療現(xiàn)象普遍加重了醫(yī)療保險統(tǒng)籌基金負(fù)擔(dān)以及職工基本呢醫(yī)療保險實(shí)際統(tǒng)籌層次偏低等問題,并且指出以上主要問題所帶來的弊端。以此,為下文所提出的完善措施提供材料。第三部分討論了域外主要醫(yī)療保險的制度模式,主要對德國、我國香港地區(qū)、英國與加拿大等醫(yī)療保險制度進(jìn)行了簡要的介紹,明確其中特征,比如德國醫(yī)療保險制度的主要特征在于將健康保險全民覆蓋、我國香港通過政府經(jīng)營公立醫(yī)療機(jī)構(gòu)對其實(shí)施監(jiān)管、英國實(shí)施國家衛(wèi)生服務(wù)保障制度實(shí)現(xiàn)醫(yī)療資源配置的優(yōu)化以及加拿大通過延伸醫(yī)療保險制度有效節(jié)約財(cái)政等。由此,將其中最鮮明之處予以分析,并根據(jù)我國現(xiàn)階段實(shí)際情況借鑒其成功經(jīng)驗(yàn)。第四部分通過第三部分域外醫(yī)療保險制度中的成功經(jīng)驗(yàn)進(jìn)行借鑒,旨在將該成功經(jīng)驗(yàn)與我國實(shí)際情況相結(jié)合,解決第二部分提出的我國職工基本醫(yī)療保險現(xiàn)階段存在的問題。同時,該部分提出完善我國職工基本醫(yī)療保險制度應(yīng)當(dāng)遵循的原則與具體措施,在理論與實(shí)踐相結(jié)合,最終完善我國職工基本醫(yī)療保險制度。關(guān)于職工基本醫(yī)療保險制度,由于其涉及社會學(xué)、法學(xué)、經(jīng)濟(jì)學(xué)等許多人文社會科學(xué)領(lǐng)域,而目前對該制度的研究多停留于非法學(xué)領(lǐng)域,對于制度本身的討論相對狹窄。因此,本文選擇將職工基本醫(yī)療保險法律制度作為研究課題,能夠從法學(xué)角度提出有針對性的完善原則與操作建議,具有一定的理論與實(shí)踐價值。同時,我國職工基本醫(yī)療保險制度的完善路徑某種程度可以為其他相關(guān)制度的完善提供借鑒,比如醫(yī)療保險制度范疇中的城鎮(zhèn)居民基本醫(yī)療保險制度與新型農(nóng)村合作醫(yī)療保險制度的完善。因?yàn)?職工基本醫(yī)療保險法律制度同城鎮(zhèn)居民基本醫(yī)療保險法律制度與新型農(nóng)村合作醫(yī)療保險法律制度相比較,雖然存在諸多差異,但是也存在諸多相同之處。綜上,以法學(xué)思維分析我國職工基本醫(yī)療保險法律制度,針對其中存在的問題提出解決方案,不論是對于完善我國職工基本醫(yī)療保險法律制度本身還是其他相關(guān)法律制度都具有深刻意義。
[Abstract]:At present, under the background of building the "health insurance for all" and improving the medical insurance system with Chinese characteristics, this article discusses the concept of the protection of the right to existence, the thought of social connection and the thought of social equality as the legislative purpose of the social security law, and discusses the problems in the legal system of medical insurance in our country and discusses it from the angle of law. In order to improve the design ideas of the legal system of basic medical insurance for staff and workers in China, the full text is four parts, which are the outline of the legal system of basic medical insurance for workers and workers, the main contents and existing problems of the legal system of basic medical insurance for workers and workers, the model of the medical insurance system in the developed countries (regions) and the basic medical insurance law of the workers and workers. The improvement of the law system. The four parts are successively elicited, followed by step by step. In the writing train of thought, we follow the principles of introducing the system, finding the problems, analyzing the problems and solving the problems. The first part introduces the related concepts, types and characteristics of the legal system of basic medical insurance for workers and workers, and introduces the differences between the basic medical insurance system and the related system of the workers and workers. This paper summarizes the role of the legal system of basic medical insurance for workers and workers, and provides a clear conceptual basis for the discussion of the problems in this article. The second part introduces the main contents of the legal system of basic medical insurance for workers and workers, analyzes the legal system of basic medical insurance for workers and workers in China from a historical point of view, and gives a basic medical treatment for the workers in our country at the present stage. At the same time, the main problems of the current system are analyzed, such as the fact that the actual insurance rate of the basic medical insurance of the workers is not ideal, the overburden of the medical insurance overall fund and the low level of the basic medical insurance of the staff and workers are generally aggravated, and the main questions above are pointed out. The third part discussed the system model of the major medical insurance in the outside world, mainly introduced the medical insurance system in Germany, Hongkong, Britain and Canada, and made clear the characteristics, such as the main characteristics of the German medical insurance system. The health insurance is covered by the whole people. In Hongkong, the government manages public medical institutions through the government, the UK implements the national health service guarantee system to optimize the allocation of medical resources and the effective economy of Canada through the extended medical insurance system. The fourth part uses the successful experience of the third part of the extraterritorial medical insurance system for reference. The purpose is to combine the successful experience with the actual situation of our country and solve the existing problems of the basic medical insurance in the second part of our country. At the same time, this part puts forward to perfect me. The basic medical insurance system that the basic medical insurance system of the workers and workers should follow should be combined with the theory and practice to perfect the basic medical insurance system of the staff and workers in our country. In the field of non jurisprudence, the discussion of the system itself is relatively narrow. Therefore, this paper chooses the legal system of basic medical insurance for workers as a research topic, and can put forward pertinent principles and operational suggestions from the angle of law. It has a certain theoretical and practical value. Some extent can provide reference for the improvement of other related systems, such as the basic medical insurance system of urban residents and the improvement of the new rural cooperative medical insurance system in the category of medical insurance. Compared with the legal system of treatment and insurance, although there are many differences, there are many similarities. In conclusion, the legal system of basic medical insurance for workers and workers in China is analyzed by law thinking, and the solutions are put forward for the problems existing in it, whether it is to improve the legal system of basic medical insurance in our country or other relevant laws. The law system has profound significance.

【學(xué)位授予單位】：東北財(cái)經(jīng)大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2016
【分類號】：D922.182.3

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