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吉林省城鎮(zhèn)職工基本醫(yī)療保險(xiǎn)制度存在問題與對策研究

發(fā)布時(shí)間:2018-05-31 04:03

  本文選題:城鎮(zhèn)職工 + 醫(yī)療保險(xiǎn)。 參考:《東北師范大學(xué)》2014年碩士論文


【摘要】:醫(yī)療保險(xiǎn)制度作為一項(xiàng)具有高度社會(huì)需求性的基本制度,一項(xiàng)保障和改善民生的重點(diǎn)制度,一項(xiàng)事關(guān)實(shí)現(xiàn)經(jīng)濟(jì)社會(huì)可持續(xù)發(fā)展的關(guān)鍵制度,一直以來都是我國醫(yī)療衛(wèi)生事業(yè)的重點(diǎn)建設(shè)領(lǐng)域。從計(jì)劃經(jīng)濟(jì)時(shí)代的勞保醫(yī)療和公費(fèi)醫(yī)療并行的醫(yī)療保障制度開始,基本醫(yī)療保險(xiǎn)制度中的城鎮(zhèn)職工人群始終是系統(tǒng)建設(shè)的優(yōu)先領(lǐng)域。隨著改革開放的推進(jìn),傳統(tǒng)的城鎮(zhèn)職工醫(yī)療保障體制賴以生存的制度基礎(chǔ)逐漸發(fā)生改變,勞保醫(yī)療過渡到社會(huì)醫(yī)療保險(xiǎn)的改革勢在必行。時(shí)至今日,城鎮(zhèn)職工基本醫(yī)療保險(xiǎn)制度改革的深化和推進(jìn)也成為化解“看病難、看病貴”難題的題中之義,其制度設(shè)計(jì)、運(yùn)行和管理各方面都面臨著一些問題和挑戰(zhàn)。 本文從認(rèn)識繼續(xù)推進(jìn)和深化城鎮(zhèn)職工基本醫(yī)療保險(xiǎn)制度改革的理論和現(xiàn)實(shí)意義入手,,在進(jìn)行了相關(guān)的理論準(zhǔn)備后,開始對吉林省城鎮(zhèn)職工基本醫(yī)療保險(xiǎn)制度存進(jìn)行抽絲剝繭地研究。首先就醫(yī)療保險(xiǎn)制度的相關(guān)概念、基本原則、建立意義等做出簡要回顧和強(qiáng)化,并將世界范圍內(nèi),包括德國的社會(huì)醫(yī)療保險(xiǎn)模式,美國的商業(yè)醫(yī)療保險(xiǎn)模式,英國的國家醫(yī)療保險(xiǎn)模式,新加坡的儲(chǔ)蓄醫(yī)療保險(xiǎn)模式四種典型的醫(yī)療保險(xiǎn)模式進(jìn)行了比較研究,對后文吉林省城鎮(zhèn)職工基本醫(yī)療保險(xiǎn)制度的運(yùn)行分析提供了堅(jiān)實(shí)理論基礎(chǔ)。接著,本文回溯了我國城鎮(zhèn)醫(yī)療保障制度的歷史沿革,從傳統(tǒng)的勞保醫(yī)療和公費(fèi)醫(yī)療到意識到傳統(tǒng)城鎮(zhèn)醫(yī)療保險(xiǎn)制度的弊端后的城鎮(zhèn)職工基本醫(yī)療保險(xiǎn)制度的階段性改革探索。最后,回到本文的研究重點(diǎn)吉林省城鎮(zhèn)職工基本醫(yī)療保險(xiǎn)制度存在的問題,對此筆者著重從三個(gè)角度進(jìn)行了分析,制度覆蓋面問題,尚未達(dá)到預(yù)期目標(biāo);政策管理問題,制度方案有待優(yōu)化;統(tǒng)籌層次問題,抗風(fēng)險(xiǎn)能力差。相應(yīng)的,針對提出的問題,文中也提出了對策建議,通過盡快解決歷史遺留問題和重點(diǎn)、難點(diǎn)突出的擴(kuò)面工作擴(kuò)大與提升制度覆蓋的深度與廣度;通過拓寬醫(yī)保基金的籌資來源,完善對需方的償付制度、對供方的激勵(lì)和支付制度等方面調(diào)整完善相關(guān)政策和管理機(jī)制;通過建立完善的信息平臺(tái)和繼續(xù)推進(jìn)統(tǒng)籌層次提高以期更好地發(fā)揮制度的互助共濟(jì)功能。
[Abstract]:The medical insurance system is a basic system with high social needs, a key system to protect and improve the people's livelihood, a key system related to the realization of sustainable economic and social development. All along is our country medical and health enterprise key construction domain. Starting from the parallel medical security system of labor insurance and public medical treatment in the planned economy era, the urban workers and staff members in the basic medical insurance system are always the priority areas of the system construction. With the development of reform and opening up, the system foundation on which the traditional medical insurance system for urban workers depends on is gradually changing, so it is imperative to reform the transition of labor insurance medical care to social medical insurance. Up to now, the deepening and promotion of the reform of the basic medical insurance system for urban workers has also become the meaning of resolving the difficult and expensive medical treatment. The design, operation and management of the system are facing some problems and challenges. This paper begins with the theoretical and practical significance of continuing to promote and deepen the reform of the basic medical insurance system for urban workers, and after making relevant theoretical preparations, The basic medical insurance system for urban workers in Jilin Province began to be studied. First of all, briefly review and strengthen the related concepts, basic principles and significance of the medical insurance system, and make a brief review and strengthen the social medical insurance model of the world, including the social medical insurance model of Germany, the commercial medical insurance model of the United States, etc. This paper makes a comparative study of the four typical medical insurance modes in Britain and Singapore, which provide a solid theoretical basis for the operation and analysis of the basic medical insurance system for urban workers in Jilin Province. Then, this paper retrospect the historical evolution of the urban medical security system in China, from the traditional labor insurance and public medical care to the realization of the drawbacks of the traditional urban medical insurance system after the reform of the basic medical insurance system of urban workers stage exploration. Finally, returning to the problems existing in the basic medical insurance system of urban workers in Jilin Province, the author analyzes the problems from three angles, the coverage of the system has not yet reached the expected goal, the policy management problem, The system plan needs to be optimized; the overall planning level problem, the ability to resist risk is poor. Accordingly, aiming at the problems raised, the paper also puts forward some countermeasures and suggestions, through solving the problems and key points left over by history as soon as possible, expanding and improving the depth and breadth of the coverage of the system, which is difficult and prominent; By broadening the funding sources of the medical insurance fund, perfecting the reimbursement system to the demand-side, adjusting and perfecting the relevant policy and management mechanism in the respect of the incentive and payment system of the supplier; By building a perfect information platform and continuing to promote the overall level of improvement in order to better play the system of mutual aid function.
【學(xué)位授予單位】:東北師范大學(xué)
【學(xué)位級別】:碩士
【學(xué)位授予年份】:2014
【分類號】:F842.684;R197.1

【參考文獻(xiàn)】

相關(guān)期刊論文 前9條

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