基本医保筹资作为我国基本医保制度的支柱和基础,“十四五”期间乃至更长时期必然以高质量发展为主题。为此,国家顶层设计已出台一系列政策措施,明确了改革发展的目标、原则和措施框架。但是我们能够看到,在实现改革发展目标过程中,新老问题相互交织,面临的经济社会发展环境将十分复杂多变,不确定性因素多发,医保制度本身又是复杂的系统性制度,有效应对各种挑战也将成为常态。为此,本文从医保制度顶层设计的系统目标,健康目标、经济负担和待遇公平的内在规律,重要变量的平衡关系等方面对把握好基本医保筹资进行阐述,探索建立基本医保筹资机制,构建保障适度、可持续的医疗保障体系。
Abstract
As the pillar and foundation of China's basic medical insurance system, funding will inevitably focus on high-quality development during the 14th Five-Year Plan and more. Therefore, the national top-level design has issued a series of policies, clarifying the goals, principles and framework of measures for reform and development. However, in the process of realizing the goals of reform and development, new and old problems are intertwined, and the economic and social development environment will be very complex and changeable, and there will be many uncertain factors. The medical insurance system itself is a complex system. Addressing various challenges will also become the norm. For this reason, the paper expounds on grasping the basic medical insurance financing from the aspects of the system goals of the top-level design of the medical insurance system, the internal laws of health goals, economic burden and fair treatment as well as the balance of important variables, and explores the establishment of a basic medical insurance financing mechanism and a more appropriate and sustainable medical security system.
关键词
基本医保 /
筹资 /
保障适度
Key words
basic medical insurance /
financing /
moderate guarantee
{{custom_sec.title}}
{{custom_sec.title}}
{{custom_sec.content}}
参考文献
[1] 孙华. 建立稳定多元的居民医保筹资机制[J].中国医疗保险,2022(02):45.
[2] 舒国宋,李久辉.我国基本医保筹资机制的现状、问题和对策[J].医学与哲学,2021,42(19):60-64.
[3] 李珍,张楚.论居民医保个人筹资机制从定额制到定比制的改革[J].中国卫生政策研究,2021,14(07):1-10.
[4] 朱坤. 保障适度量化下的基本医保筹资需求分析[J].中国医疗保险,2021(04):31-36.
[5] 刘均. 坚持并持续完善符合我国国情的居民医保筹资政策[J].中国医疗保险,2021(02):33-34.
[6] 张彦生,王虎峰.跨区域政策性迁移人口医疗保障衔接问题研究:以北京迁雄安新区职工医保筹资与待遇设计为例[J].中国卫生经济,2021,40(06):18-22.
[7] 刘朝一,徐伟,许正圆,钟港棚.市级统筹背景下城镇职工医保个人账户筹资政策优化研究[J].卫生经济研究,2021,38(03):40-44.DOI:10.14055/j.cnki.33-1056/f.2021.03.028.
[8] 付晓光.量能负担,建立居民医保筹资增长机制[J].中国医疗保险,2021(02):35-36.
[9] 杨燕绥,李超凡,于淼,胡乃军.医保筹资与职工医保个人账户权益置换改革[J].中国医疗保险,2020(08):10-16.DOI:10.19546/j.issn.1674-3830.2020.8.004.
[10] 彭宅文,丁怡.风险扩张、财政压力与医疗保障筹资改革:政策变迁及影响因素[J].学术研究,2020(04):103-111.
[11] 李长乐,孙静,范艳存.整合城乡居民基本医疗保险制度筹资水平的分析与预测[J].中国卫生经济,2019,38(12):18-20.
[12] 程玉敏.居民医保筹资增长与保障待遇变化比较研究——以某省城镇居民医保基金运行情况为例[J].中国农村卫生事业管理,2019,39(09):630-633+650.
[13] 袁涛. 构建医保筹资与待遇支付关联机制的理论思考[J].社会保障评论,2018,2(04):149-159.
张丽萍. 厘清医保筹资与支付的逻辑关系——基于宝鸡市职工医保运行实践[J].中国医疗保险,2017(12):38-41.DOI:10.19546/j.issn.1674-3830.2017.12.010
[14] 谢士钰,王文仪.从收支平衡看医保基金运行风险及其管控改革措施[J].中国初级卫生保健,2018,32(01):6-8.
[15] 李珍,黄万丁.全民基本医保一体化的实现路径分析——基于筹资水平的视角[J].经济社会体制比较,2017(06):138-148.
[16] 段明妍. 医保保障与筹资适宜度研究[D].东南大学,2017.
[17] 赵斌,尹纪成.我国城乡居民医保筹资机制的完善思考——基于“三险合一”改革和结构性变革的探讨[J].中国医疗保险,2017(06):15-20.DOI:10.19546/j.issn.1674-3830.2017.6.004.
[18] 谭中和. 我国职工医保筹资和待遇水平现状及对有关问题的思考[J].中国医疗保险,2017(06):9-14.DOI:10.19546/j.issn.1674-3830.2017.6.003.
