【摘要】：醫(yī)療保險(xiǎn)涉及主體多、關(guān)系復(fù)雜,始終存在道德風(fēng)險(xiǎn)、利益博弈,需要專門立法,及時(shí)制定《基本醫(yī)療保險(xiǎn)條例》,以保障制度的公平和可持續(xù)發(fā)展。但立法也面臨不少難題:醫(yī)療保險(xiǎn)制度分設(shè)、管理分割,基本制度尚未定型;有的改革舉措與社會(huì)保險(xiǎn)法規(guī)定不一致;對(duì)籌資模式、繳費(fèi)費(fèi)率、個(gè)人賬戶、待遇水平、定點(diǎn)管理、法律責(zé)任等問(wèn)題需認(rèn)真研究論證。建議人力資源和社會(huì)保障部認(rèn)真總結(jié)改革經(jīng)驗(yàn),抓緊形成新的《基本醫(yī)療保險(xiǎn)條例(草案送審稿)》,爭(zhēng)取盡快將其列入國(guó)務(wù)院立法計(jì)劃。
[Abstract]:Medical insurance involves many subjects, complex relations, always moral hazard, benefit game, need special legislation, timely formulation of "basic medical insurance regulations", in order to ensure the fair and sustainable development of the system. But the legislation also faces many difficulties: the medical insurance system is divided, the management is divided, the basic system has not been finalized, some reform measures are inconsistent with the social insurance law, the financing mode, the contribution rate, the personal account, the treatment level, Fixed-point management, legal liability and other issues need to be carefully studied and demonstrated. It is suggested that the Ministry of Human Resources and Social Security should conscientiously sum up the experience of the reform, form the new basic Medical Insurance regulations (draft for review), and strive to include them in the legislative plan of the State Council as soon as possible.
【作者單位】： 中國(guó)醫(yī)療保險(xiǎn)研究會(huì);
【分類號(hào)】：D922.182.3;F842.684

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