本文選題：城鄉(xiāng)居民大病保險(xiǎn)　切入點(diǎn)：大病保險(xiǎn)模式　出處：《南京大學(xué)》2017年碩士論文

【摘要】：重大疾病所產(chǎn)生的高額的醫(yī)療費(fèi)用,對(duì)于無保障或者保障水平不足的居民來說,會(huì)導(dǎo)致災(zāi)難性的后果,即"因病致貧、因病返貧"。我國(guó)現(xiàn)行的城鄉(xiāng)居民基本醫(yī)保制度,保障水平相對(duì)較低,未能有效緩解"因病致貧"問題,對(duì)于城鄉(xiāng)居民來說,大病所產(chǎn)生的高額醫(yī)療費(fèi)用,可謂災(zāi)難性的醫(yī)療支出,亟需更為合理有效的制度保障�；诖�,國(guó)家于2012年出臺(tái)了《關(guān)于開展城鄉(xiāng)居民大病保險(xiǎn)工作的指導(dǎo)意見》,各地由此開始試點(diǎn)實(shí)施大病保險(xiǎn)制度。本文從大病致貧的角度出發(fā),采取了理論與實(shí)證相結(jié)合的方法,分析了疾病與貧困之間的關(guān)系,研究了城鄉(xiāng)居民基本醫(yī)保和大病保險(xiǎn)制度的"緩貧、脫貧"效應(yīng),發(fā)現(xiàn)疾病(尤其是重大疾病)所產(chǎn)生的高額醫(yī)療費(fèi)用,會(huì)對(duì)個(gè)體和家庭產(chǎn)生嚴(yán)重的負(fù)面影響,如無合理的應(yīng)對(duì)機(jī)制和制度安排,甚至?xí)箓�(gè)體和家庭陷入持續(xù)性、代際性的貧困。我國(guó)的城鄉(xiāng)居民基本醫(yī)保制度解決"因病致貧、返貧"問題效果欠佳,大病保險(xiǎn)制度的實(shí)行則較為有效地解決了"因病致貧"問題,太倉(cāng)、湛江、青海三種大病保險(xiǎn)模式,都取得了不錯(cuò)的成效,可供不同社會(huì)經(jīng)濟(jì)發(fā)展水平地區(qū)借鑒。我國(guó)城鄉(xiāng)居民大病保險(xiǎn)制度實(shí)施以來,取得了非常顯著的效果,保障效應(yīng)持續(xù)放大,"因病致貧"問題得到了較為有效的緩解。本文基于實(shí)證研究和對(duì)我國(guó)大病保險(xiǎn)實(shí)施的總體情況進(jìn)行分析,發(fā)現(xiàn)我國(guó)大病保險(xiǎn)制度效果雖然顯著,但也存在一些問題,本文認(rèn)為,應(yīng)在"精準(zhǔn)扶貧"大背景下,健全完善我國(guó)大病保險(xiǎn)制度,繼續(xù)提高保障水平、合理設(shè)定報(bào)銷起付線和封頂線、精準(zhǔn)定位保障對(duì)象、提高統(tǒng)籌層次、簡(jiǎn)化完善報(bào)銷流程、加大宣傳力度,發(fā)揮大病保險(xiǎn)制度對(duì)城鄉(xiāng)居民"因病致貧"問題的"脫貧效應(yīng)",實(shí)現(xiàn)制度目標(biāo)。
[Abstract]:The high cost of medical treatment caused by major diseases will lead to disastrous consequences for the residents who have no security or inadequate level of protection, that is, "poor because of illness, return to poverty because of illness".The current basic medical insurance system for urban and rural residents in China has a relatively low level of security and has not effectively alleviated the problem of "poverty caused by illness". For urban and rural residents, the high medical expenses caused by serious illness can be described as catastrophic medical expenses.More reasonable and effective system guarantee is urgently needed.Based on this, in 2012, the state issued the "guidelines on the development of urban and rural residents' serious illness insurance", and all localities began to pilot implement the serious illness insurance system.From the point of view of causing poverty by serious illness, this paper analyzes the relationship between disease and poverty by combining theory and practice, and studies the effects of basic medical insurance and insurance system on serious illness in urban and rural areas.Finding that high medical costs associated with diseases, especially major diseases, can have serious negative effects on individuals and families, such as the absence of reasonable coping mechanisms and institutional arrangements, and even perpetuate individuals and families,Intergenerational povertyThe basic medical insurance system for urban and rural residents in China solves the problem of "poverty caused by illness, returning to poverty", and the implementation of the insurance system for serious illness has solved the problem of "poverty caused by illness" more effectively. Three major illness insurance modes, Taicang, Zhanjiang and Qinghai, have been implemented.Both have achieved good results and can be used for reference in areas with different levels of social and economic development.Since the implementation of the insurance system for serious illness of urban and rural residents in China, it has achieved very remarkable results, the effect of protection has been continuously amplified, and the problem of "poverty caused by illness" has been more effectively alleviated.Based on the empirical study and the analysis of the general situation of the implementation of the major illness insurance in China, this paper finds that although the effect of the insurance system of our country is remarkable, there are still some problems.Perfect and perfect our country's serious illness insurance system, continue to improve the level of protection, rationally set the starting line and ceiling line for reimbursement, accurately locate the object of protection, raise the overall planning level, simplify and perfect the reimbursement process, and increase propaganda,Give full play to the "poverty relief" effect of the serious illness insurance system on urban and rural residents'"poverty caused by illness", and realize the system goal.
【學(xué)位授予單位】：南京大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2017
【分類號(hào)】：R197.1;F842.684

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