本文選題：城鄉(xiāng)居民醫(yī)療保險 + 政策體系��； 參考：《新疆大學》2017年碩士論文

【摘要】：我國自1998年、2003年相繼建立了城鎮(zhèn)職工醫(yī)療保險制度和新型農(nóng)村合作醫(yī)療制度,將城鎮(zhèn)職工和農(nóng)村居民納入了保障范圍。在兩項制度取得良好成效的基礎(chǔ)上,2007年,國務(wù)院面向全國,選取了79個城市開展城鎮(zhèn)居民醫(yī)療保險試點。東營市作為其中一員,于2007年10月份,實施了城鎮(zhèn)居民醫(yī)療保險制度,率先構(gòu)建了由城鎮(zhèn)職工醫(yī)療保險、城鎮(zhèn)居民醫(yī)療保險、新型農(nóng)村合作醫(yī)療三項制度組成的醫(yī)療保障體系,在制度上實現(xiàn)了全覆蓋。2012年,針對城鎮(zhèn)居民醫(yī)療保險和新型農(nóng)村合作醫(yī)療制度分設(shè)所帶來的各種弊端,東營市積極借鑒先進地區(qū)經(jīng)驗,結(jié)合實際,創(chuàng)新思路,在全省率先完成了城鎮(zhèn)居民醫(yī)療保險與新型農(nóng)村合作醫(yī)療的統(tǒng)籌整合,將居民醫(yī)療保障體系從“雙軌制”轉(zhuǎn)變?yōu)椤耙粡埦W(wǎng)”,建立了統(tǒng)籌城鄉(xiāng)的居民醫(yī)療保險制度。后期,針對制度運行中出現(xiàn)的居民醫(yī)保基金支出增長過快問題,東營市歷時一年探索建立了總額控制下的組合式付費方式,實現(xiàn)了城鄉(xiāng)居民醫(yī)療保險制度的良性、健康、可持續(xù)發(fā)展。東營市城鄉(xiāng)居民醫(yī)療保險制度從政策體系的建立健全到運行體制機制的逐步優(yōu)化,各項改革工作取得了良好的社會效果,為其他地區(qū)居民基本醫(yī)療保險制度的發(fā)展提供了寶貴經(jīng)驗。然而,隨著經(jīng)濟社會的不斷發(fā)展和各項改革的逐漸深入,東營市的城鄉(xiāng)居民醫(yī)療保險事業(yè)遇到了不少問題。比如,籌資機制如何完善、統(tǒng)籌后的居民醫(yī)�；鹑绾螌崿F(xiàn)收支平衡、基層醫(yī)療衛(wèi)生服務(wù)體系建設(shè)如何加強、怎樣構(gòu)建針對老年參保群體的長期照護保險制度等等。因此,本文以東營市統(tǒng)籌城鄉(xiāng)居民醫(yī)療保險改革研究為題,以公共產(chǎn)品、福利經(jīng)濟學、社會公平與服務(wù)均等化理論為基礎(chǔ),通過文獻分析、比較研究、實地調(diào)研和歸納演繹等多種研究方法,深入分析研究東營市統(tǒng)籌城鄉(xiāng)居民基本醫(yī)療保險工作的現(xiàn)狀、問題及對策建議,旨在為豐富我國城鄉(xiāng)居民基本醫(yī)療保險統(tǒng)籌發(fā)展、改革發(fā)展的有關(guān)理論,為包括東營市在內(nèi)的其他地區(qū)居民醫(yī)療保險事業(yè)的進一步發(fā)展做出積極貢獻。本文第一章為引言部分,第二章主要介紹了統(tǒng)籌城鄉(xiāng)居民醫(yī)療保險的概念界定與理論基礎(chǔ),第三章為東營市開展統(tǒng)籌城鄉(xiāng)居民醫(yī)療保險的改革內(nèi)容和改革方式,第四章主要探究東營市城鄉(xiāng)居民醫(yī)療保險發(fā)展存在的問題并分析其產(chǎn)生原因,第五章為先進地區(qū)的經(jīng)驗借鑒,第六章有針對性地對東營市城鄉(xiāng)居民醫(yī)療保險的改革完善提出個人的對策建議。
[Abstract]:Since 1998 and 2003, China has established the urban worker medical insurance system and the new rural cooperative medical insurance system, which brings the urban workers and rural residents into the scope of security. On the basis of the good results of the two systems, in 2007, the State Council selected 79 cities to carry out the pilot program of urban residents' medical insurance. Dongying City, as one of them, implemented the medical insurance system for urban residents in October 2007, and took the lead in constructing a medical security system consisting of three systems, namely, medical insurance for urban workers, medical insurance for urban residents, and new rural cooperative medical insurance. In 2012, in view of the various drawbacks brought by the separation of urban residents' medical insurance and the new rural cooperative medical care system, Dongying actively drew lessons from the experience of advanced regions, combined with the actual situation, and innovated ideas. In the whole province, the urban residents' medical insurance and the new rural cooperative medical insurance were first integrated, the residents' medical insurance system was changed from "two-track system" to "one net", and the urban and rural residents' medical insurance system was established as a whole. In the later period, in view of the problem of the residents' medical insurance fund expenditure increasing too fast, Dongying City spent a year exploring the establishment of a combined payment method under the control of total amount, which realized the benign and healthy medical insurance system of urban and rural residents. Sustainable development The medical insurance system for urban and rural residents in Dongying City has achieved good social results from the establishment of a sound policy system to the gradual optimization of the operational system mechanism. It provides valuable experience for the development of basic medical insurance system in other areas. However, with the continuous development of economy and society and the deepening of various reforms, the medical insurance of urban and rural residents in Dongying has encountered many problems. For example, how to perfect the financing mechanism, how to balance the income and expenditure of the residents' health insurance fund, how to strengthen the construction of the primary health care service system, how to build the long-term care insurance system for the elderly insured groups and so on. Therefore, based on the theory of public goods, welfare economics, social equity and equalization of services, this paper makes a comparative study on the reform of medical insurance for urban and rural residents in Dongying, through literature analysis. Through field investigation, induction and deduction, and other research methods, this paper analyzes and studies in depth the present situation, problems and countermeasures of the basic medical insurance for urban and rural residents in Dongying, with a view to enriching the overall development of basic medical insurance for urban and rural residents in China. The relevant theories of reform and development have made positive contributions to the further development of residents' medical insurance in other areas, including Dongying City. The first chapter is the introduction, the second chapter mainly introduces the definition and theoretical basis of the urban and rural residents' medical insurance, the third chapter is the content and the way of the reform of the overall urban and rural residents' medical insurance in Dongying. The fourth chapter mainly explores the problems existing in the development of medical insurance for urban and rural residents in Dongying City and analyzes the reasons for its emergence. The fifth chapter is for the experience of advanced areas. Chapter six puts forward personal suggestions on the reform and perfection of medical insurance for urban and rural residents in Dongying.
【學位授予單位】：新疆大學
【學位級別】：碩士
【學位授予年份】：2017
【分類號】：F842.684

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