本文關鍵詞： 大病保險服務 政府 購買 問題與對策　出處：《山西大學》2016年碩士論文　論文類型：學位論文

【摘要】：2012年8月,國務院六部委(國家發(fā)改委、衛(wèi)生部、財政部、人社部、民政部、保監(jiān)會)聯(lián)合發(fā)文《關于開展城鄉(xiāng)居民大病保險工作的指導意見》,拉開了全國范圍內(nèi)政府購買城鄉(xiāng)居民大病保險服務的序幕。它是政府購買公共服務在社會保障服務領域的有益探索,是運用保險機制轉(zhuǎn)變政府職能、創(chuàng)新社會治理方式的有力舉措。城鄉(xiāng)居民大病保險政策施行三年來成效明顯與問題突出的態(tài)勢并存,總結現(xiàn)有經(jīng)驗,破解發(fā)展難題,服務于推進政策全面落實和豐富政府公共服務理論成為研究初衷。本文綜合運用結構訪談、實地調(diào)研、文獻分析、理論分析多種研究方法,以治理理論、民營化理論和合同管理為理論依據(jù),通過聚焦政府購買大病保險服務的運行現(xiàn)狀,分析了制度層面和操作層面存在的問題,最終從觀念轉(zhuǎn)變、機制完善、制度健全、能力提升四個方面為政府購買大病保險服務提出了相關的政策建議。本文由五部分構成,首先對政府購買大病保險服務的相關概念進行了界定。其次匯總了政府購買大病保險的基本情況,包括其緣起背景、政策要點、主要成效和意義,并重點進行了商業(yè)保險機構承辦城鄉(xiāng)居民大病保險的現(xiàn)實分析。接著遵循合同式管理邏輯動態(tài)分析了政府購買大病保險服務合同訂立、合同履行、合同終止與糾紛處理各環(huán)節(jié)的突出問題及原因。最后,緊扣已有問題提出了切實轉(zhuǎn)變觀念,明晰政府職能;完善相關政策法規(guī),持續(xù)優(yōu)化運作機制;建立并推行嚴格的監(jiān)督評估體系;提升政府、商業(yè)保險機構、公民參與能力這四方面協(xié)同互動的改善建議,最終推動政府職能轉(zhuǎn)變及公共服務提供方式創(chuàng)新,作用于實現(xiàn)政府治理能力和治理體系的現(xiàn)代化。
[Abstract]:In August 2012, six ministries and commissions of the State Council (the National Development and Reform Commission, the Ministry of Health, the Ministry of Finance, the Ministry of Human and Social Affairs, the Ministry of Civil Affairs, The CIRC) jointly issued a "guiding opinion on carrying out the work of serious illness insurance for urban and rural residents", which opened the prelude that the government buys the insurance service for the serious illness of urban and rural residents nationwide. It is the prelude that the government buys the public service in the social security. Useful exploration in the field of services, It is a powerful measure to change the government's functions and innovate the way of social governance by using the insurance mechanism. In the three years since the implementation of the insurance policy for urban and rural residents with serious illness, the results have obviously coexisted with outstanding problems. We have summed up the existing experience and solved the difficult problems of development. It has become the original intention of the research to serve to promote the full implementation of the policy and enrich the theory of government public service. This paper makes comprehensive use of structural interviews, field research, literature analysis, theoretical analysis of a variety of research methods to governance theory, Based on the theory of privatization and contract management, this paper analyzes the problems existing in the system and operation by focusing on the current situation of the government's purchase of the insurance service for serious illness, and finally changes the concept, improves the mechanism, and improves the system. Four aspects of ability enhancement have put forward relevant policy recommendations for the government to purchase insurance services for serious illness. This paper consists of five parts. First of all, it defines the related concepts of the government's purchase of the serious illness insurance service. Secondly, it summarizes the basic situation of the government's purchase of the serious illness insurance, including its origin background, key policy points, main effects and significance. Then, according to the management logic of contract, the conclusion of the contract for the purchase of the serious illness insurance service by the government and the fulfillment of the contract are analyzed. The problems and reasons of the termination of contract and the settlement of disputes. Finally, it puts forward the idea of changing the concept, clarifying the functions of the government, perfecting the relevant policies and regulations, and continuously optimizing the operation mechanism. To establish and implement a strict supervision and evaluation system, to enhance the four aspects of government, commercial insurance institutions and citizen participation ability, and to promote the transformation of government functions and the innovation of public service delivery methods. Function in the realization of government governance capacity and governance system modernization.
【學位授予單位】：山西大學
【學位級別】：碩士
【學位授予年份】：2016
【分類號】：R197.1;F842.684

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