新型农村合作医疗的社会保险性质探析——兼论合作医疗中“合作”的内涵  

Exploration and Analysis of the Social Security Property of New-style Rural Cooperative Medical Scheme——Concurrently Discussing the Connotation of Medical Cooperative

作　　者：刘小青[1] 

机构地区：[1]中国人民大学公共管理学院,北京100972

出　　处：《西部论坛》2014年第2期17-24,共8页West Forum

基　　金：中央高校基本科研业务费专项(中国人民大学科学研究基金)资助项目(13XNH047)

摘　　要：通过对历史资料的梳理发现,新型农村合作医疗的"合作"与传统合作医疗的"合作"具有不同的内涵。传统合作医疗不属于社会保险制度,而新农合不仅在学理上具备了社会保险基本特征,还具备了比较成熟的社会保险要素,即政府主导作用的发挥、社会保险参量的设计、大数法则的运用、权利与义务相结合的原则以及实际上的强制性。明确新农合的社会保险性质,将有利于控制自愿参合带来的"逆向选择",促进城乡基本医疗保险制度的无缝衔接,加快政府责任边界的明晰化。因此,应将新农合向带有强制性的农村基本医疗保险制度发展,同时把政府定额财政补贴变为按比例补贴。Through historical literature study, this paper finds that there are different connotations of the Cooperative between the New-style Rural Cooperative Medical Scheme （ NRCMS ） and the traditional one, the traditional cooperative medical scheme doesn’ t belong to social security system while the NRCMS not only has the basic features of social security, but also has the relatively mature elements of social security, such as the playing of government’ s leading role, the design of social security parameters, the implementation of the law of large numbers, the principle of the combination of rights and obligation and actual mandatory. The clarification of social security features of the NRCMS is helpful to control the “reverse selection” brought by voluntarily participating in the NRCMS, promotes the seamless connection between urban and rural basic medical insurance system, and speeds up the definition of the boundary of government’ s responsibility. Thus, China should develop the NRCMS towards compulsory basic medical insurance system and meanwhile change the governmental quota financial subsidy to the subsidy according to a proportion.

关 键 词：新型农村合作医疗 社会保险制度 社会医疗保险 基本医疗保险制度 社会保险参量设计 大数法则 社会保障城乡一体化 社会保险要素 逆向选择 New RURAL Cooperative Medical System ( NRCMS) 

分 类 号：F842.613[经济管理—保险] F323.89