| 引用本文：李珍.迈向高质量全民统一覆盖的医疗保险制度[J].中国卫生政策研究,2020,13(1):2-8 |
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| 迈向高质量全民统一覆盖的医疗保险制度 |
| 投稿时间：2019-12-10 修订日期：2020-01-05 PDF全文浏览 HTML全文浏览 |
| 李珍 |
| 中国人民大学公共管理学院 中国人民大学健康保障研究中心 北京 100872 |
| 摘要:我国医疗保险特色是在二元经济结构上建立了全民基本医保体系，因此职工医疗保险与居民医疗保险呈二元结构，发展不平衡且居民医疗保险发展不充分，这一问题只能在经济发展过程中渐进解决。文章主张通过强制参保实现人人享有保险，通过属地参保和职工以家庭为单位参保，可增加职工参保人，减少居民参保人，在当前筹资机制大体不变的情况下，职工家庭成员可快速提高保障水平，同时随居民医疗保险参保人减少，财政补贴大体不变时，人均筹资水平可实现较快增长。到21世纪中叶当市民化率达70%左右时，二元制度可融为一体，实现高质量全民统一覆盖的制度目标。 |
| 关键词:全民统一覆盖 强制参保 属地参保 职工家庭联保 |
| 基金项目:国家医保局委托重大项目"2050年医疗保障战略目标与‘十四五’重点任务研究"(2019K20256) |
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| Towards a medical insurance system with high quality and universal coverage |
| LI Zhen |
| School of Public Administration and Policy, Health Security Research Center, Renmin University of China, Beijing 100872, China |
| Abstract:The paper emphasized that the characteristic of basic medical insurance in China should be the establishment of national basic medical insurance system in a dual economic structure. Therefore, the basic medical insurance for employees and residents is defined in a dual structure. The development is unbalanced and the insurance level of medical insurance for residents is insufficient. This problem can only be solved gradually in the process of economic development. The article also argues that through the policy of compulsory insurance, territorial insurance and employees' unified family insurance, the number of employees can be increased to support a big number of people having access to medical insurance, which can in turn reduce the number of residents with individual insurance. Under the condition that the current financing mechanism is basically unchanged, employees' family members can quickly improve the insurance level through the unified family insurance policy. At the same time, with the decrease in number of residents' individual medical insurance, and the financial subsidies generally unchanged, the per capita financing level can grow rapidly. By the middle of this century, when the citizenization rate reaches about 70%, the dual system can be integrated to achieve the goal of high-quality and universal coverage with balanced economic development and sufficient level of residents' medical insurance. |
| Key words:Universal Coverage Compulsory Insurance Territorial Insurance Employees' unified family insurance |
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