| 引用本文：冉晓醒, 仇雨临.身份归属与医保制度分割：平台就业者参保困局及出路[J].中国卫生政策研究,2023,16(3):9-15 |
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| 身份归属与医保制度分割：平台就业者参保困局及出路 |
| 投稿时间：2022-12-27 修订日期：2023-03-03 PDF全文浏览 HTML全文浏览 |
| 冉晓醒1, 仇雨临2 |
1. 北京大学人口研究所 北京 100871;
2. 中国人民大学中国社会保障研究中心 北京 100872 |
| 摘要:数字技术在劳动领域的全方位嵌入催生出大量平台就业岗位，平台企业以突破传统的灵活用工模式吸纳了大批劳动者，但也导致平台就业者的身份归属不明。在我国城镇职工医保与城乡居民医保分设的背景下，平台就业者参保陷入困局：一方面是平台就业者参加职工医保存在困难，以职工或者灵活就业身份参保受到多重条件约束；另一方面是平台就业者参加居民医保效用不足，异地报销受限且保障待遇不充分。由此产生就医行为被扭曲、非连续参保、国家财政压力加大等负向连锁效应。医疗保险制度包容性发展是破解平台就业者参保困局的重要途径。通过创设新型参保身份，将平台就业者纳入职工医保范畴，构建多方共担缴费责任、缴费要素适用的参保方案，不断完善参保管理机制，促进医疗保险动态包容发展。 |
| 关键词:医疗保险 平台就业者 参保困局 包容性发展 |
| 基金项目:国家社科基金重点项目 (20AZD076)；中国博士后科学基金第72批面上项目(2022M720250) |
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| Identity attribution and medical insurance segmentation: The dilemma and the way out for platform employees |
| RAN Xiao-xing1, QIU Yu-lin2 |
1. Institute of Population Research, Peking University, Beijing 100871, China;
2. China Social Security Research Center, Renmin University of China, Beijing 100872, China |
| Abstract:Platform enterprises create a large number of platform jobs with the all-round embedding of digital technology, which appeal to lots of employees due to their tradition-breaking employment model, but they fail to certainty the employment status of platform workers. In the context of the separation of urban employees' medical insurance and urban and rural residents' medical insurance in China, platform employees are caught in a dilemma: on the one hand, it is difficult for platform employees to participate in employees' medical insurance, and their participation as employees or flexible workers is subject to multiple limitations; on the other hand, the effectiveness of platform employees' participation in residents' medical insurance is insufficient, and their reimbursement is restricted in different places and their compensation is compromised. As a result, negative knock-on effects such as distorted medical behavior, discontinuous participation, and increased financial pressure on the state occur. The article argues that the inclusive development of the health insurance system is an important way to break the dilemma of platform employees. By creating a new type of status, platform employees can be included into the scope of employees' medical insurance, and hence guarantee a dynamic and inclusive development of health insurance by constructing an insurance scheme with multiple parties sharing the responsibility for payment, and applying payment elements. |
| Key words:Medical insurance Platform employees The dilemma of insurance participation Inclusive development |
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