论文部分内容阅读
目的:提高我国医疗保险统筹层次。方法:通过分析目前我国医疗保险统筹层次偏低(即主要为县级统筹)带来的种种弊端,提出逐步提高我国基本医疗保险统筹层次、实现市级统筹的建议。结果与结论:统筹层次偏低存在不能满足保险的大数法则、增加了异地就医的情况、加大了管理成本、不利于制度整合发展等弊端。建议建立基本医疗保险的市级统筹,在地市级行政区划范围内实现基本医疗保险制度的统一政策、统一基金和统一管理服务,并建议按“基础层→政策层→管理层”的路线加以实现。
Objective: To improve the overall level of medical insurance in China. Methods: By analyzing the shortcomings of the current overall level of medical insurance in China (that is, mainly for the county-level co-ordination), this paper puts forward suggestions for gradually raising the overall level of China’s basic medical insurance and realizing the overall planning at the municipal level. RESULTS AND CONCLUSION: There exists the principle of large numbers that can not meet the insurance requirements at a low level of overall coordination, which increases the situation of medical treatment in different places, increases the management cost and is not conducive to the system integration and development. It is suggested that a unified plan of basic medical insurance should be established at the municipal level for the basic medical insurance and a unified policy for the basic medical insurance system should be established within the scope of the prefecture-level administrative division. The unified fund and the unified management service should be proposed. It is suggested that the basic medical insurance should be based on the “basic level → policy level → management level” Route to be achieved.