重大疫情医疗费用公共化的理论逻辑与实现路径——基于新冠肺炎重大疫情的反思  

Theoretical Logic and Realization Path of the Publicization of Medical Expenses for Major Epidemics——Reflections based on the Major Epidemic of COVID-19

作　　者：曹信邦 CAO Xin-bang(School of Management Science and Engineering,Nanjing University of Information Science and Technology,Nanjing 210044,China)

机构地区：[1]南京信息工程大学管理工程学院,南京210044

出　　处：《理论探讨》2020年第5期11-16,共6页Theoretical Investigation

基　　金：国家社会科学基金重点项目“中国失能老人长期照护财务供给多元主体融合机制、模式与制度架构研究”(16AGL014)阶段性成果。

摘　　要：新冠肺炎重大疫情暴发以来,患者医疗费用是由个人负担、社会保险负担还是政府财政负担,已经成为社会广泛争议的话题。人类的发展史就是一部重大疫情的抗争史,由于重大疫情发生的频次越来越高,患者的医疗费用总额大、负担较重,重大疫情已经成为重大社会风险。患者医疗费用的非制度化不利于公众的国家认同感,需要建立重大疫情医疗费用公共化制度。重大疫情的灾难性特征决定了保险不是化解医疗费用风险的最优手段,社会成员健康的外部性特征决定了公共财政具有不可推卸的责任,建立重大疫情应急储备基金制度应是重大疫情医疗费用公共化的实现路径。重大疫情应急储备基金制度应由"政府为主、社会参与的筹资体系,平战结合的预案体系,科学合理的基金管理体系"等共同构成。Since the epidemic of COVID-19 occurs,it has become a widely debated topic whether the medical expenses of patients should be borned by individuals,social insurance or government finance.The history of human development is a history of fighting against major epidemics.Due to the increasing frequency and the medical expense,the major epidemics have become a major social risk.The non-institutionalization of patients’medical expenses is not conducive to the public’s sense of national identity,so it is necessary to establish a public system of medical expenses for major epidemics.The catastrophic characteristics of major epidemics determine that insurance system may be not the best choice to defuse the risk,but the externality of health of social members determines that public finance has an inescapable responsibility,that is to say,the emergency reserve fund for major epidemics is the available way to cover the public medical expenses of major epidemics.Therefore,the major epidemic emergency reserve fund system should consist of a financing system dominated by the government and with the participation of the public,a pre-plan system combined with peacetime and wartime,and a scientific and reasonable fund management system.

关 键 词：新冠肺炎疫情 医疗费用 公共化 应急储备基金 重大疫情 

分 类 号：D63-3[政治法律—政治学]