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我国城乡居民基本医疗保险制度整合研究发表职称论文

博今文化 / 2019-10-26
我国城乡居民基本医疗保险制度整合研究 发布时间:2019-03-13

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  保险硕士论文第二篇:我国城乡居民基本医疗保险制度整合研究
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  本篇文章目录导航:

  【题目】我国城乡居民基本医疗保险制度整合研究
  【第一章】浅析我国城乡居民基本医保制度整合的必要性
  【第二章】城乡居民基本医疗保险制度整合现状及问题分析
  【第三章】关于完善城乡居民基本医疗保险制度整合的对策
  【第四章】城乡居民基本医疗保险制度整合结论及参考文献

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  摘 要

  城乡居民基本医疗保险制度的整合是一项惠及民生的重大工程。党的十八大报告在改善民生和创新社会管理中,明确提出统筹推进城乡社会保障体系建设,整合城乡居民基本养老保险制度和基本医疗保险制度,全面建成覆盖城乡居民的社会保障体系。党的十九大报告在加强社会保障体系建设中也提出,全面建成覆盖全民、城乡统筹、权责清晰、保障适度、可持续的多层次社会保障体系,全面实施全民参保计划,完善统一的城乡居民基本医疗保险制度。

  2018 年 1 月 3 日,国务院以国发〔2018〕3 号印发《关于整合城乡居民基本医疗保险制度的意见》。该意见要求按照全覆盖、保基本、多层次、可持续的方针,加强统筹协调与顶层设计,遵循先易后难、循序渐进的原则,从完善政策入手,推进城镇居民医保制度和新农合制度的整合,逐步在全国范围内建立起统一的城乡居民基本医疗保险制度,快速发表职称论文,使得保障更加公平、管理服务更加规范、医疗资源利用更加有效,从而促进全民医保体系持续健康发展。2018 年 7 月国家医疗保障局会同财政部、人力资源社会保障部、国家卫生健康委员会联合印发《关于做好 2018 年城乡居民基本医疗保险工作的通知》,这是国家层面首次从统筹城乡的角度,对城乡居民医保年度重点工作进行统一部署。国家三令五申,相关部门积极推进,从一个侧面证明了城乡居民基本医疗保险制度整合在保护公民健康权益、保障民生、促进社会公平正义等方面具有较强的现实意义。

我国城乡居民基本医疗保险制度整合研究发表职称论文

  本文采取的研究方法包括定量与定性分析、实证与规范分析的方法。通过分析我国城乡居民基本医疗保险制度实施以来出现的问题,总结了部分区域城乡居民基本医疗保险整合的经验,提出了完善我国城乡居民基本医疗保险制度整合的对策。

  论文共分如下几部分:

  第一部分:城乡居民基本医疗保险制度整合的一般理论。首先,对城镇职工基本医疗保险制度、新型农村合作医疗制度、城镇居民基本医疗保险制度和城乡居民基本医疗保险制度整合等概念进行了界定。其次,分析了我国城乡居民基本医疗保险制度整合的必要性:城乡居民医疗保险制度整合是中国特色社会主义民生观理论的题中之意,是实现城乡居民健康公平的内在要求,是社会医疗保障体系发展的必然要求,是管理并实现医疗保障目标的需要。再次,探讨了我国城乡居民基本医疗保险制度整合的可行性:城镇居民医保制度与新农合制度设计的原理一致,居民参保率稳步提高奠定了城乡居民基本医疗保险制度整合的基础,地方探索为全面整合城乡居民基本医保制度提供实践经验,人民日益增长的美好生活需要是整合城乡居民基本医疗保险制度的推动力。

  第二部分:我国城乡居民基本医疗保险制度整合现状分析。首先,总结了我国城乡居民基本医疗保险制度整合取得的四项成就:参保人员的医疗待遇水平整体提升;医疗机构管理更加规范、细化;医疗保险管理部门更加合理利用城乡居民的信息资源;异地就医即时结算使城乡居民更加公平地享受医疗保障权利。其次,高级工程师职称论文,指出了我国城乡居民基本医疗保险制度整合过程中面临的四个大问题:城乡居民基本医疗保险制度整合过程存在隐性不公平现象;城乡居民基本医疗保险制度整合缺乏合理可持续的筹资和支付机制;在城乡居民基本医疗保险制度整合过程中存在服务断接现象;基层医疗保险水平有限导致门诊统筹能力差。再次,分析了我国城乡居民基本医疗保险制度整合过程中面临问题的原因:经济发展不平衡是城乡居民基本医疗保险制度整合的瓶颈;城乡医疗卫生资源配置失衡;地方政府工作的主观能动性不强;医疗法制的不健全成为城乡居民基本医疗保险制度整合的短板。

  第三部分:完善我国城乡居民基本医疗保险制度整合的思考。首先,提出了我国城乡居民基本医疗保险制度整合的目标是在全国范围内建立覆盖城乡居民的统一的国民健康保险制度。要实现这一目标,需要通过三个路径:第一,优先整合信息系统;第二,优化整合经办机构服务;第三,深化支付方式改革,增强风险防范意识,加强基金运行分析。其次,探讨了我国城乡居民基本医疗保险制度整合的四个对策:做好顶层设计推进制度整合进程;建立公平的、稳定的筹资机制和财政补贴机制;建立不同医保制度之间的转移接续机制;完善门诊统筹保障机制。

  从近几年的实践看,城乡居民基本医疗保险制度整合作为一项保障城乡居民健康权益的重要政策,在实现城乡居民人人享有基本医疗保障权益、促进社会公平正义的价值目标下,从部分地区的先行试点,到国家层面的顶层设计,再到全国范围内的全面实施,毕业论文发表,已经取得了一定的实效,这对保障城乡居民公平享有基本医保权益、助力打赢脱贫攻坚战和全面建成小康社会具有重要意义。

  关键词:城乡居民 医疗保险 整合

  Abstract

  The integration of the basic medical insurance system for urban and rural residents is amajor project benefiting the people's livelihood. In improving people's livelihood andinnovating social management, the report of the 18th national congress of the communistparty of China (CPC) clearly proposed to promote the overall development of the urban andrural social security system, integrate the basic medical insurance system for urban and ruralresidents, and build a comprehensive social security system covering both urban and ruralresidents. The 19th CPC national congress also proposed to improve the unified medicalinsurance system for urban and rural residents.

  On January 3, 2018, the state council printed “the opinion of integration of urban andrural residents basic medical insurance system " on the [2018] No. 3. According to the whole,basic, multilevel and sustainable rule, the “opinion” requests that we should strengthenoverall coordination and top-level design, following the principle from easy to difficult, andpromote the integration of medical insurance for urban residents and the new ruralcooperative system, so we can gradually establish a unified urban and rural residents healthcare system across the country. We will ensure greater fairness, better management ofservices, more effective use of medical resources, and promote the sustainable and healthydevelopment of the universal health care system. In July 2018, the national health insurancebureau with the ministry of finance , the ministry of human resources and social securityand the national health committee jointly issued , which makes unified arrangementsfor key annual medical insurance programs for urban and rural residents for the first time thenational level from the perspective of urban and rural planning. The state has repeatedlyordered and relevant departments have actively promoted it, which proves from the side theintegration of the basic medical insurance system for urban and rural residents, which hasproved from one side that the integration of basic medical insurance system for urban andrural residents has strong practical significance in protecting citizens' health rights andinterests, ensuring people's livelihood, promoting social equity and justice.The research methods adopted in this paper include quantitative and qualitative,empirical and normative analysis. By analyzing the problems of the basic medical insurancesystem for urban and rural residents since its implementation, this paper summarizes theexperience of the basic medical insurance system for urban and rural residents in someregions, and probes into some countermeasures for the integration of the basic medicalinsurance system of urban and rural residents in China.

  The paper is divided into the following parts:

  Part one: the general theory of medical insurance integration of urban and rural residents.

  First, it defines the basic medical insurance system for urban workers, the new ruralcooperative medical service system, the basic medical insurance system for urban residents,medical assistance for urban and rural residents and the integration of basic medical insurancefor urban and rural residents. Secondly, it analyses the necessity of integrating basic medicalinsurance for urban and rural residents in China. It is the topic of the theory of the socialistview of people's livelihood with Chinese characteristics, the inherent requirement of realizingthe health and equity of urban and rural residents, an inevitable requirement for thedevelopment of the social medical security system, and a need to manage and realize the goalof medical security. Thirdly, it discusses the feasibility of integrating basic medical insurancefor urban and rural residents in China: The current basic medical insurance system for urbanresidents is consistent with the design principle of the new rural cooperative medical system.

  Steady improvement of residents' participation rate lays the foundation for the integration ofthe basic medical insurance system for urban and rural residents . Local exploration providespractical experience for the comprehensive implementation of the integrated basic medicalinsurance system for urban and rural residents. The people's growing need for a better life isthe impetus to integrate basic medical insurance for urban and rural residents.

  Part two: the analysis of the current situation of the integration of basic medicalinsurance for urban and rural residents in China. First, it summarizes the four achievements ofthe integration of medical insurance for urban and rural residents in China, including thewhole promotion of medical treatment level for the insured; The management of medicalinstitutions is more standardized and detailed; Medical insurance management departmentsmake more rational use of information resources of urban and rural residents; Instantsettlement of out-of-town medical treatment enables urban and rural residents to enjoy moreequitable medical security rights. Secondly, it points out the four problems faced by theintegration of the basic medical insurance for urban and rural residents in China: There areimplicit unfair constraints in the integration process of the basic medical insurance system forurban and rural residents ; The integration of the basic medical insurance system for urbanand rural residents lacks reasonable and sustainable finance and payment mechanism; It leadsto a service disconnect during the integration of the basic medical insurance for urban andrural residents; The limited level of primary medical insurance leads to poor out-patientcoordination. Thirdly, it analyzes the reasons of the problems faced by the integration of basicmedical insurance for urban and rural residents in China: Unbalanced Economic developmentis the bottleneck of the integration of the basic medical insurance for urban and rural residents;Unbalanced allocation of medical and health resources in urban and rural areas; Thesubjective initiative of local government is not enough; The imperfection of medical legalsystem becomes the weak part of the integration of the basic medical insurance for urban andrural residents.

  Part three: Improve the thinking on the integration of basic medical insurance system forurban and rural residents in China. First, it puts forward the goal and path of the integration ofthe basic medical insurance system of urban and rural residents in China: the goal is toestablish a unified national health insurance system covering urban and rural residentsnationwide. It needs three paths: First, prioritize integration of information systems; Second,optimize and integrate the agency services; Third, deepen the reform of the payment method,increase the awareness of risk prevention and strengthen analysis of fund operations.

  Secondly, it discusses the four countermeasures to integrate the basic medical insurancesystem of urban and rural residents in China: Carry out the system integration process oftop-level design well; Establish equitable and stable financing mechanisms and fiscal subsidymechanisms; Establish the transfer and connection mechanism between different medicalinsurance systems; Improve the coordination and guarantee mechanism of outpatient service.

  Looking from the practice of recent years, as an important public policy, the integrationof urban and rural residents medical insurance system has a great effect on the health rightsand interests of urban and rural residents. With the goal of realizing the rights and interests ofeveryone who will have access to basic medical and health care for urban and rural residents,from pilot projects in some regions, to top-level design at the national level, and tocomprehensive implementation across the country, we have achieved certain progress, whichis of great significance to ensure that urban and rural residents have equitable access to basicmedical insurance, help us win the battle against poverty, and lay a solid foundation forbuilding a prosperous society in all respects.

  Key words:Urban and rural residents Medical insurance Integratio
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  目 录

  摘要

  引言

  (一) 选题背景与研究意义
  1. 选题背景
  2. 研究意义
  (二) 国内外研究现状
  1. 国内研究现状
  2. 国外研究现状
  (三) 研究思路与研究方法
  1. 研究思路
  2. 研究方法
  (四) 重点难点及创新点
  1. 重点难点
  2. 创新之处

  一、 我国城乡居民基本医疗保险制度整合概述

  (一) 概念的界定
  1. 城镇职工基本医疗保险制度
  2. 新型农村合作医疗制度
  3. 城镇居民基本医疗保险制度
  4. 城乡居民基本医疗保险制度整合
  (二) 我国城乡居民基本医疗保险制度整合的必要性
  1. 落实中国特色社会主义民生观理论的需要
  2. 实现城乡居民健康公平的内在要求
  3. 社会医疗保障体系发展的必然要求
  4. 管理并实现医疗保障目标的需要
  5. 减轻国家和地方政府财政负担的重要措施
  (三) 我国城乡居民基本医疗保险制度整合的可行性
  1. 城镇居民医保制度与新农合制度设计的原理一致
  2. 居民参保率稳步提高奠定了制度整合的基础
  3. 地方探索为全面制度整合提供实践经验
  4. 人民日益增长的美好生活需要是制度整合的推动力

  二、 我国城乡居民基本医疗保险制度整合的现状分析

  (一) 我国城乡居民基本医疗保险制度整合取得的成就
  1. 参保人员的医疗待遇水平整体提升.
  2. 医疗机构管理更加规范和细化
  3. 医疗保险管理部门更加合理利用城乡居民的信息资源
  4. 城乡居民的医疗保障权利更加具有公平性
  (二) 我国城乡居民基本医疗保险制度整合过程中存在的问题
  1. 城乡居民基本医疗保险制度整合过程存在隐性不公平现象
  2. 城乡居民基本医疗保险制度整合缺乏合理的可持续的筹资机制
  3. 城乡居民基本医疗保险制度在整合过程中存在服务断接现象
  4. 基层医疗保险水平有限导致门诊统筹能力差.
  (三) 我国城乡居民基本医疗保险制度整合过程中存在问题的原因
  1. 经济发展不平衡是制度整合的瓶颈.
  2. 城乡医疗卫生资源配置失衡
  3. 地方政府工作的主观能动性不强
  4. 医疗法制的不健全成为制度整合的短板

  三、 对我国城乡居民基本医疗保险制度整合的思考

  (一) 城乡居民基本医疗保险制度的整合目标及路径
  1. 城乡居民基本医疗保险制度的整合目标
  2. 城乡居民基本医疗保险制度的整合路径
  (二) 完善城乡居民基本医疗保险制度整合的对策
  1. 做好顶层设计推进制度整合进程
  2. 建立公平的、稳定的筹资机制和财政补贴机制
  3. 建立不同医保制度之间的转移接续机制
  4. 完善门诊统筹保障机制

  结论

  参考文献