| 引用本文：王超群, 胡杨, 张超, 陈兆婷, 陶丽丽.从定额制到费率制——代理家计调查视角下城乡居民医保个人缴费标准设定[J].中国卫生政策研究,2022,15(10):10-17 |
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| 从定额制到费率制——代理家计调查视角下城乡居民医保个人缴费标准设定 |
| 投稿时间：2022-09-12 修订日期：2022-09-29 PDF全文浏览 HTML全文浏览 |
| 王超群1, 胡杨1, 张超1, 陈兆婷1, 陶丽丽2 |
1. 华中师范大学公共管理学院 湖北武汉 430079;
2. 上海市第六人民医院 上海 201306 |
| 摘要:一直以来，我国城乡居民医保实行个人定额缴费。定额缴费便于理解、操作简单，但是也带来了筹资不公平和筹资能力有限等问题。本文引入代理家计调查方法，使用2019年中国家庭金融调查(CHFS)数据预测家庭收入，并按照预测家庭收入的一定比例缴费，即实行代理家计调查下的费率制。研究发现，费率制虽然仅能有限改善筹资公平性，但是却能够大幅降低低收入群体缴费负担、提高城乡居民医保筹资能力和减轻财政补助负担等。本文建议，将城乡居民医保个人缴费由定额制改为费率制。为此，应推动城乡居民医保相关配套改革，如实行强制参保，加强部门间信息共享，不断优化预测模型等。 |
| 关键词:城乡居民医保 定额制 费率制 代理家计调查 |
| 基金项目:华中师范大学2022年大学生创新创业训练计划项目(202210511010)；2021年度上海市第六人民医院院级科学研究基金(DY2020025) |
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| From quota system to rate system: The setting of individual contribution standard of medical insurance for urban and rural residents from the perspective of proxy means-tests |
| WANG Chao-qun1, HU Yang1, ZHANG Chao1, CHEN Zhao-ting1, TAO Li-li2 |
1. School of Public Administration, Central China Normal University, Wuhan Hubei 430079, China;
2. Shanghai Sixth People's Hospital, Shanghai 201306, China |
| Abstract:Urban and rural residents have been paying a fixed rate for medical insurance all the time. The fixed rate bring along problems like inequitable funding and limited funding capacity despite its easiness to understand and simplicity to operate. This paper predicts household income on the basis of data collected in China Household Financial Survey (CHFS) in 2019 with the Proxy means-tests (PMT), and proposes a proportional rate of payment according to the predicted household income, i.e. the rate system based on the Proxy means-tests (PMT). It is found that the rate system can greatly reduce the burden of payment among low-incomers and improve the financing capacity of medical insurance for urban and rural residents thus to reduce the burden of financial subsidies, though it improves equity in funding on a limited sacle.This paper suggests that the individual payment for medical insurance for urban and rural residents be changed from a fixed rate system to a rate system. Therefore, supporting reforms related to medical insurance for urban and rural residents such as compulsory participation, more efficient information sharing among departments, and constantly optimizing predictmodels, ect. need to be carried out. |
| Key words:Medical insurance for urban and rural residents Fixed rate system Rate system Proxy means-tests |
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