發(fā)布時間：2018-05-29 22:11

  本文選題：社會醫(yī)療保險 + 城鄉(xiāng)統(tǒng)籌　； 參考：《遼寧大學》2013年碩士論文

【摘要】：我國是城鄉(xiāng)二元分割的經濟社會結構，社會醫(yī)療保險制度二元分割、多維運行的體制是二元社會結構的具體體現(xiàn)。隨著經濟和生產力的發(fā)展，這種二元的社會結構逐漸成為經濟社會深層次改革和進一步發(fā)展的桎梏。醫(yī)療保險制度的二元結構阻礙了勞動力的跨地域流動，也造成重復參保、財政重復補貼、管理經辦資源重復投入等巨大浪費。上述情況降低了經濟運行的效率，不公平不合理的再分配機制也直接影響了社會主義和諧社會的構建。為解決這些問題，部分地方政府根據黨中央、國務院的指示，，結合當?shù)貙嶋H情況，進行醫(yī)療保障領域的相關改革探索，創(chuàng)造出帶有“地方性”和“區(qū)域性”特點的實踐模式。其中，成都市統(tǒng)籌城鄉(xiāng)醫(yī)療保險制度改革就是一個成功的典范，為其它地區(qū)，尤其是經濟欠發(fā)達地區(qū)提供了參考借鑒的藍本。 沈陽市地處東部經濟區(qū)，城鄉(xiāng)居民收入水平較高且差距較小，同時具備較高的城鎮(zhèn)化水平。但沈陽醫(yī)療保險制度至今仍然沿用城鄉(xiāng)二元運行的體制，嚴重阻礙了生產力的發(fā)展和社會的公平進步。本文的目的是闡述成都市的成功實踐是否可以被沈陽市所借鑒。第一章詳細研究了成都市城鄉(xiāng)醫(yī)療保險制度在政策、管理體制、經辦體制及制度設計等方面的創(chuàng)新。第二章分析了成都市統(tǒng)籌城鄉(xiāng)醫(yī)療保險制度改革取得的成效及其成功的關鍵原因，同時指出改革過程中面臨的挑戰(zhàn)和問題。第三章主要從兩個城市經濟發(fā)展水平、城鄉(xiāng)居民收入差距、城鎮(zhèn)化水平、政府財政能力及政府的改革意愿等角度加以對比，深入地分析了成都市統(tǒng)籌城鄉(xiāng)醫(yī)療保險制度的模式是否可以被沈陽市所借鑒。結論是沈陽市較成都市具備更優(yōu)裕的統(tǒng)籌城鄉(xiāng)醫(yī)療保險制度條件，并且沈陽市在政治、經濟、制度和社會支持度等方面都具備了統(tǒng)籌城鄉(xiāng)醫(yī)療保險制度的現(xiàn)實基礎。第四章則結合沈陽市的實際情況,借鑒成都市統(tǒng)籌城鄉(xiāng)醫(yī)保的成功做法，因地制宜地提出沈陽市統(tǒng)籌城鄉(xiāng)醫(yī)療保險制度的總體構思和具體的政策建議，包括“三步走”的發(fā)展路徑、多層次籌資和補償機制的建立、統(tǒng)籌層次的提升、管理機構的統(tǒng)一、經辦資源的整合、城鄉(xiāng)醫(yī)保政策和經辦流程的統(tǒng)一等建議。
[Abstract]:Our country is the economic and social structure of the dual division of urban and rural areas, the dual division of the social medical insurance system, the system of multidimensional operation is the concrete embodiment of the dual social structure. With the development of economy and productive forces, this dual social structure has gradually become the shackles of the deep reform and further development of economic society. The dual structure of the medical insurance system hinders the labor force from moving across regions, and it also results in huge waste, such as repeated participation in insurance, repeated subsidy of finance, repeated input of administrative resources, and so on. The above situation has reduced the efficiency of economic operation, and the unfair and unreasonable redistribution mechanism has directly affected the construction of a harmonious socialist society. In order to solve these problems, some local governments, according to the instructions of the CPC Central Committee and the State Council, combined with the actual local conditions, carried out relevant reform and exploration in the field of medical security, and created a practical model with the characteristics of "local" and "regional". Among them, the reform of urban and rural medical insurance system in Chengdu is a successful example, which provides a reference for other regions, especially for the less developed areas. Shenyang is located in the eastern economic zone, the income level of urban and rural residents is higher and the gap is small, at the same time, it has a higher level of urbanization. However, Shenyang medical insurance system still follows the dual operation system of urban and rural areas, which seriously hinders the development of productive forces and the fair progress of society. The purpose of this paper is to explain whether the successful practice of Chengdu can be used for reference by Shenyang. The first chapter studies the innovation of urban and rural medical insurance system in Chengdu in terms of policy, management system, administration system and system design. The second chapter analyzes the effect of urban and rural medical insurance system reform in Chengdu and the key reasons for its success. At the same time, it points out the challenges and problems in the process of reform. The third chapter compares the economic development level of the two cities, the income gap between urban and rural residents, the level of urbanization, the financial capacity of the government and the willingness of the government to reform. This paper deeply analyzes whether the mode of urban and rural medical insurance system in Chengdu can be used for reference by Shenyang. The conclusion is that Shenyang has more favorable conditions than Chengdu in coordinating urban and rural medical insurance system, and Shenyang has the realistic foundation of urban and rural medical insurance system in politics, economy, system and social support. The fourth chapter combines the actual situation of Shenyang, draws lessons from the successful practice of urban and rural medical insurance in Chengdu, and puts forward the overall concept and specific policy recommendations of the overall urban and rural medical insurance system in Shenyang according to local conditions. It includes the development path of "three steps", the establishment of multi-level financing and compensation mechanism, the promotion of overall planning level, the unification of management organization, the integration of administrative resources, the unification of urban and rural medical insurance policy and operation process, and so on.
【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;R197.1

【參考文獻】

相關期刊論文 前6條

1 陳健生;陳家澤;余夢秋;;城鄉(xiāng)基本醫(yī)療保障一體化:目標模式、發(fā)展路徑與政策選擇——以成都市城鄉(xiāng)基本醫(yī)療保障統(tǒng)籌試點為例[J];理論與改革;2009年06期

2 馬蔚姝;何寧;;統(tǒng)籌城鄉(xiāng)醫(yī)療保險制度模式比較分析[J];理論與現(xiàn)代化;2012年05期

3 都文;;進一步完善醫(yī)�；I資機制——關于都江堰市城鄉(xiāng)居民醫(yī)療保險的思考[J];四川勞動保障;2011年11期

4 張廷平;;圍繞統(tǒng)籌城鄉(xiāng)發(fā)展 構建全民醫(yī)保體系[J];四川勞動保障;2008年09期

5 蘇偉;;成都統(tǒng)籌城鄉(xiāng)醫(yī)療保險的示范意義[J];四川勞動保障;2011年06期

6 張廷平;;借助市場機制作用 發(fā)揮“集團購買”優(yōu)勢——成都市推進醫(yī)療保險談判的實踐與思考[J];四川勞動保障;2012年04期

本文編號：1952632