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引用本文:余小豆, 张开然, 王红波.平台灵活就业人员基本医保参保机制研究——国际经验与中国启示[J].中国卫生政策研究,2024,17(4):-30
平台灵活就业人员基本医保参保机制研究——国际经验与中国启示
投稿时间:2024-03-21  修订日期:2024-04-11  PDF全文浏览  HTML全文浏览
余小豆1, 张开然1, 王红波2
1. 中国人民大学公共管理学院 北京 100872;
2. 山西医科大学管理学院 山西晋中 030600
摘要:数字经济推动了经济增长和就业模式变革,但也使依托于数字平台的灵活就业人员面临基本医保权益缺失的风险。本文基于包容性治理理论构建了“机会—过程—结果”的参保机制三维分析框架,分析了国际上平台灵活就业人员基本医保参保机制的经验,并结合中国实际情况提出了基本医保参保机制的优化建议。研究发现,实现医疗保险之全民健康的价值取向、包容协调的参保机制、共享统一的公平待遇,是国际上处理平台灵活就业人员医疗保险参保问题的主要策略。因此,提出以下建议:首先以健康权至上的观念,拓展完善覆盖全民、统一的基本医疗保险制度;其次促进利益相关主体间的协同发展,以提升基本医保参保的制度韧性;最后强化基本医保的互助共济功能,促进基本医保的共同富裕效应。
关键词:平台灵活就业人员  基本医疗保险  参保机制  包容性治理
基金项目:中国人民大学“中央高校建设世界一流大学(学科)和特色发展引导专项资金”支持项目
Research on the participation mechanism of basic medical insurance for platform workers: International experiences and implications for China
YU Xiao-dou1, ZHANG Kai-ran1, WANG Hong-bo2
1. School of Public Administration and Policy, Renmin University of China, Beijing 100872, China;
2. School of Management, Shanxi Medical University, Jinzhong Shanxi 030600, China
Abstract:The digital economy promotes economic growth and changes in employment patterns, but it also exposes platform workers to the risk of losing their basic medical insurance rights and interests. Based on the theory of inclusive governance, this paper constructs a three-dimensional analysis framework of opportunity-process-result for the participation mechanism, analyzes the international experiences of basic medical insurance participation mechanism for platform workers, and puts forward suggestions for optimizing the basic medical insurance participation mechanism in light of China’s actual situation. The finding shows that the value orientation of realizing the universal health of medical insurance, the inclusive and coordinated participation mechanism, and the fair treatment of sharing and unification are the main strategies to deal with the issue of medical insurance participation of platform workers in the international arena. Therefore, it is recommended to firstly, expand and improve the basic medical insurance system covering the whole population with the concept of the supremacy of the right to health; secondly, promote the synergistic development among the stakeholders to enhance the systemic resilience of the basic medical insurance; and lastly, strengthen the function of mutual assistance and mutual aid of the basic medical insurance to promote the common prosperity effect of the basic medical insurance.
Key words:Platform workers  Basic medical insurance  Participation mechanism  Inclusive governance
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