本文選題：新農(nóng)合籌資　切入點：適度水平　出處：《遼寧大學》2013年碩士論文

【摘要】：新型農(nóng)村合作醫(yī)療作為新的政策制度，不僅是對中國社會保障制度的豐富與完善，更是對農(nóng)村社會保障體系的創(chuàng)新與改革。因為傳統(tǒng)的農(nóng)村合作醫(yī)療已經(jīng)不能滿足農(nóng)民日益增長的醫(yī)療服務需求，農(nóng)民“看病難、看病貴”的現(xiàn)象愈加突出，嚴重甚至導致社會不穩(wěn)定因素產(chǎn)生，基于上述原因，政府相關(guān)部門在反復調(diào)研、試點的基礎(chǔ)上，2003年開始，試點的方式在農(nóng)村各地推行新型農(nóng)村合作醫(yī)，人均籌資水平為30元，2007年此制度在全國范圍內(nèi)普及推廣，人均籌資水平為58.9元，參合率為86.2%，到2011年人均籌資水平為246.2元，實現(xiàn)了97%的參合率，基本實現(xiàn)全覆蓋目標。截至2012年，保險制度已經(jīng)運行了10年，一定程度上緩解了農(nóng)村居民患病就醫(yī)的經(jīng)濟負擔，為維護城鄉(xiāng)社會生存公平、農(nóng)村地區(qū)社會穩(wěn)定、農(nóng)村經(jīng)濟持續(xù)發(fā)展等方面起到了積極作用，，更是彌補了農(nóng)村醫(yī)療保障制度的空白。 新型農(nóng)村合作醫(yī)療雖然取得了一定的顯著成效，但是制度本身依舊存在不完善之處，諸如：籌資水平偏低；籌資沒有動態(tài)調(diào)整機制；籌資與實際醫(yī)療需求相脫節(jié)等問題。本文嘗試在相關(guān)理論指導下，通過運用多種統(tǒng)計分析方法，基于農(nóng)民可支配收入、農(nóng)民醫(yī)療支出、政府財政動態(tài)補貼等三方面確定新農(nóng)合適度籌資水平，并給出兩種適度籌資水平方案。在科學分析測算方案的基礎(chǔ)上，為提高農(nóng)村醫(yī)療保險水平、全國社會保障水平提出相應的對策與建議。 本文主要分為以下五個組成部分： 第一部分相關(guān)理論概述。通過農(nóng)村醫(yī)療衛(wèi)生理論和農(nóng)村醫(yī)療保險籌資理論作為新型農(nóng)村合作醫(yī)療保險籌資水平研究的理論基礎(chǔ)，并具體細分為：消除城鄉(xiāng)二元社會結(jié)構(gòu)理論、城鄉(xiāng)社會保障統(tǒng)籌理論、城鄉(xiāng)居民生存公平理論、農(nóng)村居民適度負擔理論、醫(yī)療保險中的政府責任理論、醫(yī)療保險繳費責任的合理分擔理論等六個理論，為詳細說明和具體測算提供堅實的理論依據(jù)。 第二部分新農(nóng)合籌資現(xiàn)狀、存在問題及其原因分析。通過說明新農(nóng)合的運行現(xiàn)狀，進而總結(jié)新農(nóng)合籌資存在的一系列問題，并詳細分析產(chǎn)生這些問題的原因所在。 第三部分新農(nóng)合適度籌資水平分析。本文的重點部分，基于農(nóng)民可支配收入的適度籌資水平分析和基于財政動態(tài)補貼的適度籌資水平分析，進而測算新農(nóng)合籌資中各級政府和農(nóng)民個人繳費責任，確定繳費各方的籌資水平，加總個籌資主體的籌資水平，得到人均籌資水平的一套方案；基于農(nóng)民醫(yī)療支出的適度籌資水平分析，測算出新農(nóng)合人均籌資水平的第二套方案。 第四部分實現(xiàn)新農(nóng)合適度籌資水平的可行性分析。通過分析農(nóng)民收入能力、農(nóng)民醫(yī)療支出增長速度、財政支付能力，分析測得方案是否具備現(xiàn)實操作意義。 第五部分實現(xiàn)新農(nóng)合適度籌資水平的政策建議。針對存在問題，根據(jù)測算數(shù)據(jù)，提出加快農(nóng)村經(jīng)濟發(fā)展，提高農(nóng)民收入；設計農(nóng)民籌資水平動態(tài)調(diào)整機制；適度提高政府財政的籌資負擔水平；建立農(nóng)民疾病發(fā)生率及病種的信息積累機制；建立與農(nóng)民醫(yī)療需求相適應的醫(yī)療供給制度等五點政策建議，為新型農(nóng)村合作醫(yī)、農(nóng)村社會保障制度、甚至為中國社會保障制度改革出謀劃策，提供改革方向和政策依據(jù)。
[Abstract]:The new rural cooperative medical system as a new policy, not only to China social security system is to enrich and improve the innovation and reform of the rural social security system. Because the traditional rural cooperative medical care has been unable to meet the farmers' growing demand for medical services, farmers "difficult and more expensive" phenomenon is prominent serious and even lead to social instability factors, based on the above reasons, the relevant government departments in the repeated research, on the basis of the pilot, the pilot began in 2003, the implementation of the new rural cooperative medical in rural country, per capita funding level is 30 yuan, in 2007 the system of popularization in the country, per capita funding level is 58.9 yuan. The participation rate was 86.2%, by 2011 the per capita funding level is 246.2 yuan, to achieve 97% of the participation rate, the basic realization of full coverage of the target. As of 2012, the insurance system has been running for 10 In 2013, to a certain extent, it alleviated the economic burden of medical treatment for the rural residents. It played a positive role in maintaining the fairness of urban and rural social existence, the social stability in rural areas, and the sustained development of rural economy. It also made up for the gaps in the rural medical insurance system.
Although the new rural cooperative medical system has achieved remarkable results in certain, but the system itself is still not perfect, such as: low level of financing; financing no dynamic adjustment mechanism; financing is divorced from the actual medical needs and other issues. This paper attempts in the related theory, by using various statistical analysis methods, based on the disposable income of farmers. The farmers' medical expenditure, government financial subsidies and other three aspects to determine the dynamic system appropriate funding levels, and gives two kinds of moderate level of financing scheme. The calculation based on the scientific analysis methods, in order to improve the rural medical insurance level, put forward the corresponding countermeasures and suggestions of the national level of social security.
This article is divided into the following five components:
The first part is an overview of the relevant theory. The theoretical basis of rural health theory and rural medical insurance financing theory as the new rural cooperative medical insurance funding level study, and is divided into: the elimination of two urban and rural dual social structure theory, urban and rural social security theory, the theory of survival fairness between urban and rural residents, rural residents moderate burden theory, theory of government the responsibility of medical insurance, medical insurance payment responsibility allocation theory of the six theories, provide a solid theoretical basis for a detailed description and specific calculation.
The second part is about the financing status, existing problems and causes of NRCMS. By explaining the operation status of NCMS, we sum up a series of problems existing in NCMS financing, and analyze the reasons for these problems in detail.
The third part of the NCMS moderate level of financing analysis. The key part of this paper, a moderate level of financing of the disposable income of farmers and the appropriate level of funding financial subsidies based on dynamic analysis and calculation based on the NCMS funding in all levels of government and farmer individual responsibility, determine the level of financing payment of all parties, the level of funding total financing subject, get a scheme of per capita funding level; analysis of moderate level of financing farmers medical expenditure based on the estimated second scheme NCMS per capita funding level.
The fourth part is the feasibility analysis of the appropriate financing level of the new rural cooperative medical system. By analyzing the farmers' income ability, the growth rate of medical expenditure and the financial payment ability of farmers, it is analyzed whether the measurement has practical operation significance.
The new rural cooperative medical funding level moderate policy recommendations to achieve the fifth part. In view of the existing problems, put forward according to the measure data, accelerate the development of rural economy and increase farmers' income; the level of the dynamic adjustment mechanism of farmers financing design; increase the fiscal burden of financing level; establishing farmers' disease incidence and disease information accumulation mechanism; the establishment of medical supply system etc. five suggestions to adapt to the medical needs of farmers, the new rural cooperative medical, rural social security system, even for the reform of the system of social security China give advice and suggestions, provide the reform direction and policy basis.

【學位授予單位】：遼寧大學
【學位級別】：碩士
【學位授予年份】：2013
【分類號】：F323.89;F842.684;R197.1

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