我国各省“两保合一”政策分析  

Analysis on the “Integration Policy of Social Health Insurance” in Different Provinces of China

作　　者：李忠[1,2,3] 李伯阳[1,2,3] 吴悦[1,2,3] 杨坚[1,2,3] 南京辉[4] 张亮[1,2,3] 

机构地区：[1]华中科技大学同济医学院医药卫生管理学院,武汉430030 [2]湖北省人文社科重点研究基地农村健康服务研究中心,武汉430030 [3]中德农村健康联合研究中心,武汉430030 [4]华中科技大学同济医学院附属协和医院人事处,武汉430030

出　　处：《中国卫生经济》2017年第6期28-31,共4页Chinese Health Economics

基　　金：国家自然科学基金项目(71673099);湖北省科技支撑计划(软科学研究类)(2015BDF064)

摘　　要：目的:归纳医保整合过程可能存在的问题,为相关政策制定、实施与调整提供建议。方法:通过收集国家及各省政府、卫生计生、人社部门网站中有关城镇居民医疗保险和新型农村合作医疗制度整合的相关政策文件、政府报告,对比各省医保整合文件中管理权归属、统一范围、层次、筹资机制、执行目录等基本情况。结果:各省时间进度略有差别,管理权多归属人社部门,统一范围、筹资机制等也有所不同,并给出了潜在问题的解决思路。结论:应充分认识到整合过程中可能存在的问题,做好顶层设计和监控体系,同时加强宣传教育。Objective： To analyze potential problems in the social health insurance integration process, thus providing references for the formulation, implementation and improvement of related policy making. Methods： Documents and reports, related to the integration between Urban Resident-based Basic Medical Insurance Scheme and that of rural areas, were collected from the national and provincial Commission of Health and Family Planning, Department of Human Society. It compared the administration authority ownership. coverage, hierarchy, financing mechanism and executive lists on benefits package of different provinces. Results： Fewer differences were reviewed on the time schedule of the process and the most of the administrative authorities were put under the Department of Human Society. Meanwhile, coverage, financing mechanism, executive lists on benefits package and others were different from each other at the provincial level. Moreover, strategies for the potential problems were given. Conclusion： The potential problems should he emphasized and top-level design, monitoring system, publicity and education were critical during the implementation.

关 键 词：城镇居民基本医疗保险 新型农村合作医疗 医疗保险整合 卫生政策 

分 类 号：F842.684[经济管理—保险] R197.1[医药卫生—卫生事业管理]