中国补充医疗保险发展:成效、问题与出路  

The Development of Supplementary Medical Insurance in China:Achievements,Problems and Solutions

作　　者：贾洪波[1] 阳义南[2] 

机构地区：[1]北京航空航天大学社会保障研究所,北京100191 [2]中山大学岭南学院,广东广州510275

出　　处：《中国软科学》2013年第1期81-92,共12页China Soft Science

基　　金：2009年教育部人文社会科学一般研究项目(09YJC840004);中央高校基本科研业务费项目(YWF-11-06-012);中国药学会医药政策研究中心委托项目

摘　　要：经过十几年的发展,中国补充医疗保险已经取得了逐步被大多数人群所认知、和基本医疗保险的关系定位基本明确、种类和覆盖面逐渐增加、运营方式的灵活性显著增强、保障效果逐步显现这五个方面的成绩。但是补充医疗保险发展依然面临着相应的法律法规不健全、政府的角色错位、风险管控困难、和基本医疗保险的有效衔接度低、发展不均衡、参与医药卫生服务体系建设能力低下的问题。中国应该树立正确的补充医疗保险发展理念、厘清政府在补充医疗保险中的责任、实现补充医疗保险和基本医疗保险的有效衔接以及补充医疗保险内部之间的有效衔接、加强补充医疗保险专业化业务能力建设、探索补充医疗保险参与医药卫生服务体系建设、完善补充医疗保险发展所需要的相关配套制度来逐步完善补充医疗保险制度。The supplementary medical insurance in China has already gotten five achievements including knowing by many people,the clear relation with the basic medical insurance,increasing categories and coverage,obvious running flexibility,and gradual appearance of security effects after more than ten years development.At the same time,the development of the supplementary medical insurance in China also faces many problems such as the imperfect related laws and regulations,the improper role of government,the difficulty of risk controlling and management,the low effective combination with the basic medical insurance,the unbalanced development and the low capability to take part in the construction of health system.China should establish the proper logos to develop the supplement medical insurance,determine the appropriate government responsibility to the supplement medical insurance,realize the effective combination of supplementary medical insurance with the basic medical insurance and effectively internal combination of the supplementary medical insurance,strengthen the construction of special business capability of supplementary medical insurance,explore the construction of supplementary medical insurance to participate in the construction of health system and improve the matching policies related to the development of supplementary medical insurance to perfect the supplementary medical insurance gradually.

关 键 词：补充医疗保险 成效和问题 制度改进 

分 类 号：F842.684[经济管理—保险]