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城镇居民基本医疗保险试点工作,关系到参保扩面、基金收支、个人负担等问题,通过对南平市延平区的试点情况分析认为,目前城镇居民医保面临“两难”的处境,一方面保障待遇水平低,个人缴费相对较高,政策缺少吸引力,扩面难度大;另一方面参保人数少,筹资水平低,基金抗出险能力弱。要从根本上摆脱目前困境,需居民医保与新农合实行整合,建议建立城乡居民一体的基本医疗保障制度,居民医保与新农合基金统筹,执行统一政策、统一标准、统一管理。
The pilot project of basic medical insurance for urban residents is related to such issues as the expansion of insurance coverage, fund receipts and expenditures, and personal burdens. Based on the analysis of the pilot projects in Yanping District of Nanping City, the present situation of urban residents’ medical insurance is faced with the situation of “dilemma” In terms of guaranteed treatment, the level of treatment is low, the individual’s contribution is relatively high, the policy lacks attractiveness and the expansion is difficult; on the other hand, the number of insured persons is small, the level of fund-raising is low, and the ability of the fund to resist risks is weak. To fundamentally get rid of the current predicament, residents need to be integrated with the new rural cooperative medical care. It is proposed to establish an integrated basic medical insurance system for both urban and rural residents. Health insurance for residents and the new rural cooperative medical fund shall be co-ordinated and unified policies shall be implemented, unified standards and unified management shall be implemented.