居民医保待遇调整机制现状及建议
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摘要
我国居民医保的待遇设计基本参照职工医保的模式,根据筹资水平、人群以及国家医改政策等进行保障范围和保障水平的设计和调整,但目前尚未建立起明晰、稳定、完善的待遇调整机制。未来应在法律保障、治理体系、精算技术和相关制度保障等方面发力,建立起适应我国国情的居民医保待遇调整机制。
The design of the treatment of residents' medical insurance in China is basically based on the model of employee medical insurance. According to the fundraising level,the population and the national medical reform policy,the design and adjustment of the scope and level of protection are carried out. However,a clear,stable,and perfect treatment adjustment mechanism has not yet been established.In the future,efforts should be made in the areas of legal guarantee,governance system,actuarial technology,and related system guarantees to establish a adjustment mechanism for residents' medical insurance benefits that suits China's national conditions.
The design of the treatment of residents' medical insurance in China is basically based on the model of employee medical insurance. According to the fundraising level,the population and the national medical reform policy,the design and adjustment of the scope and level of protection are carried out. However,a clear,stable,and perfect treatment adjustment mechanism has not yet been established.In the future,efforts should be made in the areas of legal guarantee,governance system,actuarial technology,and related system guarantees to establish a adjustment mechanism for residents' medical insurance benefits that suits China's national conditions.
引文
[1]世界卫生报告2010.卫生系统筹资:实现全民覆盖的道路[R].世界卫生组织,2010.
[2]潘沛力.职工基本医疗保险待遇的合理设定研究[D].上海大学.
[3]许玲丽.社会统筹支付在居民终生医疗支出中的分担作用研究——对城镇职工基本医疗保险政策的实证研究[J].世界经济文汇,2011(2):69-86.
[4]王超群,李珍.从顶层设计角度看城镇职工基本医疗保险个人账户出路[J].东岳论丛,2015(2):21-25.
[5]蒋成文.医保待遇调整的实践及相关问题分析——基于贵州省的实践[J].中国医疗保险,2012(6):43-45.
[6]娄宇.论基本医保筹资和待遇依法设定和调整的法治化[J].中国医疗保险,2016(5):18-20.
[7] World Bank. Governing Mandatory Health Insurance_Learning from Experience.2008.
[2]潘沛力.职工基本医疗保险待遇的合理设定研究[D].上海大学.
[3]许玲丽.社会统筹支付在居民终生医疗支出中的分担作用研究——对城镇职工基本医疗保险政策的实证研究[J].世界经济文汇,2011(2):69-86.
[4]王超群,李珍.从顶层设计角度看城镇职工基本医疗保险个人账户出路[J].东岳论丛,2015(2):21-25.
[5]蒋成文.医保待遇调整的实践及相关问题分析——基于贵州省的实践[J].中国医疗保险,2012(6):43-45.
[6]娄宇.论基本医保筹资和待遇依法设定和调整的法治化[J].中国医疗保险,2016(5):18-20.
[7] World Bank. Governing Mandatory Health Insurance_Learning from Experience.2008.