重构医疗保险体系视角下的新农合发展研究  

Research on the Development of the New Rural Cooperative Medical Scheme in Perspective of Reconstitution the Medical Insurance System

作　　者：李珍[1] 刘小青[1] 

机构地区：[1]中国人民大学公共管理学院,北京100872

出　　处：《卫生经济研究》2014年第2期3-8,共6页

基　　金：985工程优势学科创新平台项目

摘　　要：重构医疗保险体系的基本思路是，短期之内城镇“三网合一”，新农合独立运行，当城镇化率达到70％～80％时，自然实现城乡医疗保险一体化。新农合面临的主要问题是尚未实现应保尽保，筹资水平和保障水平低，发展的关键在于完善基本制度。建议确定新农合的社会保险性质，实施强制性属地参保原则；实行财政按收入比例、个人按家庭人均纯收入比例的筹资机制，随着新型城镇化的发展，农村人口减少，新农合人均筹资水平自然提高；基本医疗保险实行按统一目录报销，提高保障水平。The basic way to unify the system of medical insurance is, in short term, to unify the three nets in cities and towns, and allow the New Rural Cooperative Medical Scheme （NRCMS） to be developed dependently; When real urban rate reaches 70-80%, natural integration of urban rural medical insurance will be achieved. There are main problems that the NRCMS has not protected all residents in rural, its financing level and security level are both low. The key of its development is to improve the basic system. This paper suggests that the nature of social insurance of the NRCMS should be defined and people should be forced to participate in the system according to where they live; The financial mechanism by proportion should be implemented, and with the development of the new urbanization, the per capital financing level will increase naturally; If all of the basic medical insurance reimburse according to catalogues, the level of protection will be increased.

关 键 词：新农合 基本医疗保险 筹资水平 保障水平 

分 类 号：R197[医药卫生—卫生事业管理]