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由成都市統(tǒng)籌城鄉(xiāng)醫(yī)保改革引發(fā)對(duì)沈陽市醫(yī)保制度的思考

發(fā)布時(shí)間:2018-05-29 22:11

  本文選題:社會(huì)醫(yī)療保險(xiǎn) + 城鄉(xiāng)統(tǒng)籌; 參考:《遼寧大學(xué)》2013年碩士論文


【摘要】:我國是城鄉(xiāng)二元分割的經(jīng)濟(jì)社會(huì)結(jié)構(gòu),社會(huì)醫(yī)療保險(xiǎn)制度二元分割、多維運(yùn)行的體制是二元社會(huì)結(jié)構(gòu)的具體體現(xiàn)。隨著經(jīng)濟(jì)和生產(chǎn)力的發(fā)展,這種二元的社會(huì)結(jié)構(gòu)逐漸成為經(jīng)濟(jì)社會(huì)深層次改革和進(jìn)一步發(fā)展的桎梏。醫(yī)療保險(xiǎn)制度的二元結(jié)構(gòu)阻礙了勞動(dòng)力的跨地域流動(dòng),也造成重復(fù)參保、財(cái)政重復(fù)補(bǔ)貼、管理經(jīng)辦資源重復(fù)投入等巨大浪費(fèi)。上述情況降低了經(jīng)濟(jì)運(yùn)行的效率,不公平不合理的再分配機(jī)制也直接影響了社會(huì)主義和諧社會(huì)的構(gòu)建。為解決這些問題,部分地方政府根據(jù)黨中央、國務(wù)院的指示,,結(jié)合當(dāng)?shù)貙?shí)際情況,進(jìn)行醫(yī)療保障領(lǐng)域的相關(guān)改革探索,創(chuàng)造出帶有“地方性”和“區(qū)域性”特點(diǎn)的實(shí)踐模式。其中,成都市統(tǒng)籌城鄉(xiāng)醫(yī)療保險(xiǎn)制度改革就是一個(gè)成功的典范,為其它地區(qū),尤其是經(jīng)濟(jì)欠發(fā)達(dá)地區(qū)提供了參考借鑒的藍(lán)本。 沈陽市地處東部經(jīng)濟(jì)區(qū),城鄉(xiāng)居民收入水平較高且差距較小,同時(shí)具備較高的城鎮(zhèn)化水平。但沈陽醫(yī)療保險(xiǎn)制度至今仍然沿用城鄉(xiāng)二元運(yùn)行的體制,嚴(yán)重阻礙了生產(chǎn)力的發(fā)展和社會(huì)的公平進(jìn)步。本文的目的是闡述成都市的成功實(shí)踐是否可以被沈陽市所借鑒。第一章詳細(xì)研究了成都市城鄉(xiāng)醫(yī)療保險(xiǎn)制度在政策、管理體制、經(jīng)辦體制及制度設(shè)計(jì)等方面的創(chuàng)新。第二章分析了成都市統(tǒng)籌城鄉(xiāng)醫(yī)療保險(xiǎn)制度改革取得的成效及其成功的關(guān)鍵原因,同時(shí)指出改革過程中面臨的挑戰(zhàn)和問題。第三章主要從兩個(gè)城市經(jīng)濟(jì)發(fā)展水平、城鄉(xiāng)居民收入差距、城鎮(zhèn)化水平、政府財(cái)政能力及政府的改革意愿等角度加以對(duì)比,深入地分析了成都市統(tǒng)籌城鄉(xiāng)醫(yī)療保險(xiǎn)制度的模式是否可以被沈陽市所借鑒。結(jié)論是沈陽市較成都市具備更優(yōu)裕的統(tǒng)籌城鄉(xiāng)醫(yī)療保險(xiǎn)制度條件,并且沈陽市在政治、經(jīng)濟(jì)、制度和社會(huì)支持度等方面都具備了統(tǒng)籌城鄉(xiāng)醫(yī)療保險(xiǎn)制度的現(xiàn)實(shí)基礎(chǔ)。第四章則結(jié)合沈陽市的實(shí)際情況,借鑒成都市統(tǒng)籌城鄉(xiāng)醫(yī)保的成功做法,因地制宜地提出沈陽市統(tǒng)籌城鄉(xiāng)醫(yī)療保險(xiǎn)制度的總體構(gòu)思和具體的政策建議,包括“三步走”的發(fā)展路徑、多層次籌資和補(bǔ)償機(jī)制的建立、統(tǒng)籌層次的提升、管理機(jī)構(gòu)的統(tǒng)一、經(jīng)辦資源的整合、城鄉(xiāng)醫(yī)保政策和經(jīng)辦流程的統(tǒng)一等建議。
[Abstract]:Our country is the economic and social structure of the dual division of urban and rural areas, the dual division of the social medical insurance system, the system of multidimensional operation is the concrete embodiment of the dual social structure. With the development of economy and productive forces, this dual social structure has gradually become the shackles of the deep reform and further development of economic society. The dual structure of the medical insurance system hinders the labor force from moving across regions, and it also results in huge waste, such as repeated participation in insurance, repeated subsidy of finance, repeated input of administrative resources, and so on. The above situation has reduced the efficiency of economic operation, and the unfair and unreasonable redistribution mechanism has directly affected the construction of a harmonious socialist society. In order to solve these problems, some local governments, according to the instructions of the CPC Central Committee and the State Council, combined with the actual local conditions, carried out relevant reform and exploration in the field of medical security, and created a practical model with the characteristics of "local" and "regional". Among them, the reform of urban and rural medical insurance system in Chengdu is a successful example, which provides a reference for other regions, especially for the less developed areas. Shenyang is located in the eastern economic zone, the income level of urban and rural residents is higher and the gap is small, at the same time, it has a higher level of urbanization. However, Shenyang medical insurance system still follows the dual operation system of urban and rural areas, which seriously hinders the development of productive forces and the fair progress of society. The purpose of this paper is to explain whether the successful practice of Chengdu can be used for reference by Shenyang. The first chapter studies the innovation of urban and rural medical insurance system in Chengdu in terms of policy, management system, administration system and system design. The second chapter analyzes the effect of urban and rural medical insurance system reform in Chengdu and the key reasons for its success. At the same time, it points out the challenges and problems in the process of reform. The third chapter compares the economic development level of the two cities, the income gap between urban and rural residents, the level of urbanization, the financial capacity of the government and the willingness of the government to reform. This paper deeply analyzes whether the mode of urban and rural medical insurance system in Chengdu can be used for reference by Shenyang. The conclusion is that Shenyang has more favorable conditions than Chengdu in coordinating urban and rural medical insurance system, and Shenyang has the realistic foundation of urban and rural medical insurance system in politics, economy, system and social support. The fourth chapter combines the actual situation of Shenyang, draws lessons from the successful practice of urban and rural medical insurance in Chengdu, and puts forward the overall concept and specific policy recommendations of the overall urban and rural medical insurance system in Shenyang according to local conditions. It includes the development path of "three steps", the establishment of multi-level financing and compensation mechanism, the promotion of overall planning level, the unification of management organization, the integration of administrative resources, the unification of urban and rural medical insurance policy and operation process, and so on.
【學(xué)位授予單位】:遼寧大學(xué)
【學(xué)位級(jí)別】:碩士
【學(xué)位授予年份】:2013
【分類號(hào)】:F842.684;R197.1

【參考文獻(xiàn)】

相關(guān)期刊論文 前6條

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