城乡居民医保筹资机制可持续性研究——以天津市为例  

Study on the Sustainability of Fund Raising Mechanism in Basic Medical Insurance System for Urban and Rural Residents of Tianjin

作　　者：朱铭来[1] 李涛[1] 

机构地区：[1]南开大学卫生经济与医疗保障研究中心,天津300071

出　　处：《中国医疗保险》2016年第5期26-29,共4页China Health Insurance

基　　金：教育部人文社会科学重点研究基地重大项目"我国社会发展与民生保障战略研究:以构建公平和可持续的医疗保障体系为例"(项目号13JJD840004)的资助

摘　　要：天津市城乡居民基本医疗保险自2010年整合以来,筹资和保障水平均有较大提高。本文通过对该市城乡居民基本医疗保险政策的梳理,对筹资和保障待遇进行了分析,并且对未来"十三五"和"十四五"时期的居民基本医疗保险基金的运行情况进行测算。笔者认为,未来天津市城乡居民基本医疗保险基金的持续发展需要适当提高个人筹资比重,建立与经济发展、财政收入和居民可支配收入增长相同步的筹资机制,控制医保基金支出的不合理增长,适当调整保障待遇水平。Since the integration of basic medical insurance for urban residents and new rural cooperative medical insurance for rural residents in Tianjin in 2010, the levels of fund raising and security have been increased greatly. In this paper, we summarized the current fi nancing system of basic medical insurance of Tianjin, analyzed the methods of funding raising and the level of treatment, and predicted the balance of this fund in 13 th and 14 th fi ve-year plan period. We argue that to ensure the sustainable development of the basic medical insurance fund in Tianjin, we should properly increase personal fi nancing weight, establish a fund raising mechanism which is synchronously grown with economic development, fiscal income and disposable personal income, and control unreasonable healthcare expenditure. We also made suggestions on how to adjust benefi t level of insurance properly.

关 键 词：城乡居民基本医疗保险 筹资机制 可持续发展 

分 类 号：R197.1[医药卫生—卫生事业管理] F842.684[医药卫生—公共卫生与预防医学]