城乡医疗保障制度的统筹模式分析——基于福利效应视角

随着城市化进程的推进,城乡二元医疗保障与经济社会发展的不适应性渐现.在此背景下,全国各地广泛开展了统筹城乡医疗保障的实践探索.而从参保人福利的角度,受收入、医保待遇差异的影响,农村居民有效医疗需求不足、医疗负担过重的现象普遍存在,通过统筹城乡医疗保障制度来缩小城乡待遇差距,减轻农村居民医疗消费的收入约束是解决这一问题的关键.我国目前正在试点的统筹城乡医疗保障的模式可以分为“全统一”模式、“二元分层基金统一”模式、“二元分层基金分设”模式三种,只有因地制宜地选择适合本地实际的统筹模式,才能更好发挥其效用.

Analysis on the Overall Planning of Urban-rural Medical Care Security System from the Angle of Welfare Effect

With the acceleration of urbanization,the incompatibility between the urban-rural binary medical care security and the social economic development began to reveal itself.Under this context,the practice and pilot studies of overall-planned urban-rural medical care security has been conducted in different regions of China.From the angle of insurance buyers′ welfare and under the influence of income and medical insurance treatment differences,the lack of effective medical demand and the overburdening of medical cost are widespread.Therefore,the key to solving the problem is to shorten the urban-rural treatment gap and reduce the income restriction of rural residents medical care consumption through the comprehensive arrangement of urban-rural medical care security system.The presently pilot-studied comprehensive arrangement of urban-rural medical care security mode can be divided into three modes:whole unification,binary layered fund unification,binary layered fund separation and these modes can be brought to their best use only when they are selected to suit the local conditions.