可行能力理论视域下的贫困人群医疗保障现状及健康扶贫对策——以广西壮族自治区为例  

The Current Situation of Health Care for the Poor and the Countermeasures of Health Poverty Alleviation in the Perspective of the Theory of Feasible Capacity——a Case Study of the Guangxi Zhuang Autonomous Region

作　　者：王前强[1] 董秋红[1] 黄李凤[1] 周一[1] 刘亚军[1] Wang Qianqiang Dong Qiuhong Huang Lifeng Zhou Yi Liu Yajun ete(College of Humanities and Social Sciences, Guangxi Medical University,Nanjing,530021)

机构地区：[1]广西医科大学人文社会科学学院,南宁530021

出　　处：《中国医疗保险》2017年第7期32-37,共6页China Health Insurance

基　　金：世界卫生组织(WHO)2014年西部卫生行动项目:卫生公平性研究(NO.03301214009)

摘　　要：调查结果显示:绝大部分的贫困人群在参加新农合等医保以后,面对重特大疾病仍然无法享受到切实的医疗保障,贫困人口"看病难"问题仍然严峻。基于可行能力理论视角,要改善广西贫困人群医疗保障不足的现状,仅简单地把贫困人群免费纳入医保体系,而忽视贫困人群实际医疗保障水平及其获得应有保障权利能力低下的实际状况,会直接降低健康扶贫政策的实际绩效。主要原因包括贫困人群的可行能力低下、获得高端医疗服务的交易成本太高和普惠式的健康扶贫制度设计等。主要政策建议:在公立医院为贫困人口建立就医诊疗"绿色通道";实施贫困人群免费医疗政策(即包括与医疗相关的费用由政府全包的政策);改革特重大疾病医保和医疗救助的政策和程序,缩小覆盖面,降低非必要的交易成本;完善社会支持系统,提高贫困人群的医疗保障可行能力等,切实提高医疗卫生服务可及性。The survey results show that the vast majority of the poor in the NCMS and other medical insurance, in the face of heavy diseases still can not enjoy the actual medical security, poor population ＂difficult to see a doctor＂ problem is still grim. Based on the theory of feasible ability, to improve Ouangxi poor medical security situation of insufficient, simply put the poor free into the health insurance system, the actual level of medical security and ignore the poor and actual situation should protect the rights of the poor ability, will directly reduce the actual performance of health poverty alleviation policy. There are three main reasons for the poor performance of the poverty alleviation policy, that is, the low viability of the poor, the high transaction costs of the high-end medical services and the design of the inclusive health care system. Enhance the level of medical security of the poor health and poverty alleviation policies include： the establishment of medical treatment ＂Easy Access＂ for the impoverished population in public hospitals; the implementation of the policy of free medical treatment of poor people （including medical and related expenses from the all inclusive government policy）; reform severe disease medical insurance and medical assistance policies and procedures, narrow coverage reduce the transaction costs necessary; to improve the social support system, improve poor people＇s health care capability etc., effectively improve the availability of medical and health services.

关 键 词：可行能力理论 贫困人群 医疗保障 健康扶贫 

分 类 号：F323.8[经济管理—产业经济] R197.1[医药卫生—卫生事业管理]