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本文以社会公民权理论、社会排斥与社会融合理论及底线公平理论为基础,对我国城市医疗救助制度发展进行分析。市场经济体制下,出现了被医疗保险排斥群体的医疗保障风险。2005年,国家出台了城市医疗救助政策,在保障贫困群体健康权益,维护社会稳定,促进社会和谐发展方面起到了重要作用。但是,由于制度安排中的缺陷,其在发挥社会融合作用方面并不充分。为保障贫困群体公平享有基本医疗卫生服务,作为确保底线公平的医疗救助制度,应构建明确的理念与目标:以人人享有基本医疗卫生服务为根本出发点和落脚点,针对贫困群体医疗保障不足所表现的社会排斥,提供保障的国家应从被动出台补救政策向主动回应转变,通过积极主动的制度安排保证公民权利的实现,以达到反社会排斥、促进社会融合为目标。
Based on the theories of social citizenship, social exclusion and social integration and the theory of bottom line fairness, this paper analyzes the development of urban medical assistance system in our country. Under the market economy system, there is a risk of medical insurance being excluded by medical insurance. In 2005, the state promulgated the urban medical aid policy, which played an important role in safeguarding the health rights and interests of the poor, safeguarding social stability and promoting the harmonious development of society. However, due to deficiencies in institutional arrangements, they are not sufficient in their role as social cohesion. In order to ensure that the poor people have equal access to basic medical and health services, as a medical assistance system to ensure a fair bottom line, a clear concept and objective should be established: to provide basic medical and health services for all as the basic starting point and end point, and to address the insufficiency of medical insurance for the poor groups The social exclusion and guarantee of the performance should be changed from the passive introduction of remedial policies to the active response and the realization of civil rights guaranteed through proactive institutional arrangements so as to achieve anti-social exclusion and promote social integration.