我國醫(yī)療保險基金財務(wù)會計信息披露研究
發(fā)布時間：2018-12-17 00:30
【摘要】：醫(yī)療保險是為補(bǔ)償參保者因疾病風(fēng)險造成的經(jīng)濟(jì)損失而建立的一項社會保險制度，，醫(yī)療保險基金為保障參保者的基本醫(yī)療、由用人單位和個人繳費(fèi)而籌集建立的專項基金。社會保險法規(guī)定：社會保險經(jīng)辦機(jī)構(gòu)負(fù)責(zé)醫(yī)療保險基金的籌集、管理和支付，并要建立健全預(yù)決算制度、財務(wù)會計制度和內(nèi)部審計制度；醫(yī)療保險經(jīng)辦機(jī)構(gòu)應(yīng)當(dāng)定期向社會公布醫(yī)療保險基金情況、醫(yī)療保險基金的收入、支出、結(jié)余和收益情況；國務(wù)院財政部門、社會保險行政部門、審計機(jī)關(guān)對社會保障基金的收支、管理和投資運(yùn)營情況實(shí)施監(jiān)督。但在實(shí)際運(yùn)行中，醫(yī)療保險基金的管理和運(yùn)營過程中暴露出許多問題，如醫(yī)療保險基金被騙取、擠占和挪用，醫(yī)療保險基金信息披露不充分、運(yùn)營信息不透明等，直接影響醫(yī)療保險制度改革的進(jìn)度和社會的和諧穩(wěn)定。 本文先對福利經(jīng)濟(jì)學(xué)的平等與效率理論、委托代理理論和博弈理論進(jìn)行分析，確立了文章的理論基礎(chǔ)；其次采用問卷調(diào)查的方法分析了醫(yī)療保險基金財務(wù)會計信息披露的主體、目標(biāo)、會計核算基礎(chǔ)、信息質(zhì)量特征等；同時采用博弈分析的方法確立了醫(yī)療保險經(jīng)辦機(jī)構(gòu)和參保者、政府監(jiān)管部門、民間監(jiān)管機(jī)構(gòu)和注冊會計師納什均衡的決策行為，在此基礎(chǔ)上構(gòu)建了以資產(chǎn)負(fù)債表、收支表和現(xiàn)金流量表為主體財務(wù)會計信息披露體系；最后提出建立多層次的財務(wù)會計信息披露體系、全方位的監(jiān)管體系和完善醫(yī)療保險信息系統(tǒng)的政策建議。文章的創(chuàng)新之處主要有兩點(diǎn)：一是在規(guī)范研究的同時輔以問卷調(diào)查，提高了規(guī)范研究的科學(xué)性和可靠性；二是構(gòu)建了以醫(yī)療保險基金資產(chǎn)負(fù)債表、收支表和現(xiàn)金流量表為主的醫(yī)療保險基金財務(wù)會計信息披露體系。
[Abstract]:Medical insurance is a social insurance system established to compensate the insured for the economic loss caused by the disease risk. The medical insurance fund is a special fund raised by employers and individuals to protect the basic medical care of the insured. The Social Insurance Law stipulates that the social insurance agencies are responsible for the collection, management and payment of medical insurance funds, and shall establish and improve the system of pre-accounting, financial accounting and internal audit; The medical insurance agency shall regularly announce to the public the status of the medical insurance fund, the income, expenditure, balance and income of the medical insurance fund; The financial department of the State Council, the administrative department of social insurance and the auditing institution shall exercise supervision over the income and expenditure, administration and investment operation of the social security fund. However, in the actual operation, many problems have been exposed in the management and operation of the medical insurance fund, such as the medical insurance fund being defrauded, embezzled and misappropriated, the information disclosure of the medical insurance fund is not sufficient, the operation information is not transparent, and so on. Directly affect the progress of medical insurance system reform and social harmony and stability. This paper first analyzes the equality and efficiency theory of welfare economics, principal-agent theory and game theory, and establishes the theoretical basis of the article; Secondly, the main body, target, accounting basis and information quality characteristics of financial accounting information disclosure of medical insurance fund are analyzed by questionnaire. At the same time, the game analysis method is used to establish the balanced decision-making behavior of medical insurance agencies and insurance providers, government regulators, private regulators and certified public accountants. On this basis, the balance sheet is constructed. Income and expenditure statement and cash flow statement are the main financial accounting information disclosure system; Finally, it puts forward the establishment of a multi-level financial and accounting information disclosure system, a comprehensive regulatory system and policy recommendations to improve the medical insurance information system. There are two main innovations in this paper: one is to improve the scientific nature and reliability of normative research by means of questionnaire survey in addition to normative research; Secondly, the financial and accounting information disclosure system of medical insurance fund is constructed, which is mainly composed of balance sheet, income and expenditure statement and cash flow statement.
【學(xué)位授予單位】：湖南大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2013
【分類號】：F840.4
本文編號：2383315
[Abstract]:Medical insurance is a social insurance system established to compensate the insured for the economic loss caused by the disease risk. The medical insurance fund is a special fund raised by employers and individuals to protect the basic medical care of the insured. The Social Insurance Law stipulates that the social insurance agencies are responsible for the collection, management and payment of medical insurance funds, and shall establish and improve the system of pre-accounting, financial accounting and internal audit; The medical insurance agency shall regularly announce to the public the status of the medical insurance fund, the income, expenditure, balance and income of the medical insurance fund; The financial department of the State Council, the administrative department of social insurance and the auditing institution shall exercise supervision over the income and expenditure, administration and investment operation of the social security fund. However, in the actual operation, many problems have been exposed in the management and operation of the medical insurance fund, such as the medical insurance fund being defrauded, embezzled and misappropriated, the information disclosure of the medical insurance fund is not sufficient, the operation information is not transparent, and so on. Directly affect the progress of medical insurance system reform and social harmony and stability. This paper first analyzes the equality and efficiency theory of welfare economics, principal-agent theory and game theory, and establishes the theoretical basis of the article; Secondly, the main body, target, accounting basis and information quality characteristics of financial accounting information disclosure of medical insurance fund are analyzed by questionnaire. At the same time, the game analysis method is used to establish the balanced decision-making behavior of medical insurance agencies and insurance providers, government regulators, private regulators and certified public accountants. On this basis, the balance sheet is constructed. Income and expenditure statement and cash flow statement are the main financial accounting information disclosure system; Finally, it puts forward the establishment of a multi-level financial and accounting information disclosure system, a comprehensive regulatory system and policy recommendations to improve the medical insurance information system. There are two main innovations in this paper: one is to improve the scientific nature and reliability of normative research by means of questionnaire survey in addition to normative research; Secondly, the financial and accounting information disclosure system of medical insurance fund is constructed, which is mainly composed of balance sheet, income and expenditure statement and cash flow statement.
【學(xué)位授予單位】：湖南大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2013
【分類號】：F840.4
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