目的: 梳理共同富裕目标下医疗救助制度托底保障功能的内涵及其实现情况,查找制约因素,提出对策建议。方法: 围绕核心问题开展文献回顾和对相关公开数据进行描述性分析。结果: 近年来,城乡医疗救助制度的总体支出规模和救助受益人次均呈现明显增长趋势,资助参保的人均救助额逐年上升,但直接救助的次均救助额有所下降;与人均参保标准和住院费用相比,资助参保人均救助额占基本医保人均缴费标准的比例出现下降趋势,次均住院救助额占居民医保参保患者次均住院费用的比例也有所降低;同时,医疗救助制度的支出水平和保障水平还存在一定的地区差异。结论: 医疗救助制度服从于推进共同富裕的最终目标,如果制度设计得当、运行高效,则可以为共同富裕目标提供有力支撑。但与不断增长的救助需求相比,近年来医疗救助制度的资金投入相对不足,导致实际救助水平有所下降,托底保障功能尚待加强。要统一思想认识、明确保障目标、优化救助政策、完善筹资机制、加强供需管理,进一步完善医疗救助制度。

Objective: The paper clarifies the connotation and implementation of the basic guarantee function of the medical assistance system under the goal of common prosperity, identifies constraining factors, and proposes countermeasures and suggestions. Methods: We conduct literature review and descriptive analysis of relevant public data concerning the core issues. Results: In recent years, the overall expenditure and number of beneficiaries of the urban and rural medical assistance system is increasing significantly. The per capita assistance for subsidized individuals is increasing year by year, while the average assistance for direct assistance is gradually decreasing. Compared with the per capita premium and hospitalization expenses, the proportion of per capita assistance for subsidized insured patients to the per capita premium for basic medical insurance dropped. Conclusion: The medical assistance system is subordinate to the ultimate goal of common prosperity. If the medical assistance system is designed properly and can be operated efficiently, it can provide strong support for the goal of common prosperity. However, compared to the growing demand for assistance, the funding investment of the medical assistance system is to some extent insufficient in recent years, resulting in a decrease in the actual level of assistance. The basic guarantee function still needs to be strengthened. We need to forge a common understanding, clarify security objectives, optimize assistance policies, improve financing mechanisms, strengthen supply and demand management, and further improve the medical assistance system.