市级统筹背景下城镇职工医保个人账户筹资政策优化研究  

Research on Optimizing Financing Policy for Individual Accounts of Urban Employees’Basic Medical Insurance at the Municipal Level

作　　者：刘朝一 徐伟[1] 许正圆 钟港棚 LIU Chao-yi;XU Wei;XU Zheng-yuan;ZHONG Gang-peng(School of International Pharmaceutical Business,China Pharmaceutical University,Nanjing Jiangsu 211198,China;不详)

机构地区：[1]中国药科大学国际医药商学院,江苏南京211198

出　　处：《卫生经济研究》2021年第3期40-44,共5页

基　　金：中国药科大学“双一流建设”科技创新团队项目(CPU2018GY43)。

摘　　要：目的:探讨基本医疗保险市级统筹背景下调整和优化职工医保个人账户筹资政策的思路和对策。方法:以江苏省S市为例,综合运用政策对比和实证分析方法,分析总结市级统筹改革中职工医保个人账户筹资政策的调整思路和实施效果。结果:S市在尽量减少政策变动的原则下,充分平衡了各统筹区的政策差异,其改革做法具有一定的借鉴意义;但职工医保个人账户统账结构失衡、基金结余过多等问题仍有待解决。结论:建议继续稳步下调在职职工个人账户划入比例,完善退休人员个人账户划入办法,进一步调整优化地方补充医保基金的筹资结构,持续推进个人账户向门诊统筹过渡。Objective To discuss the ideas and countermeasures of adjusting and optimizing the financing policy for individual accounts of urban employees’basic medical insurance at the municipal level.Methods Taking S City of Jiangsu Province as an example,this paper comprehensively uses the methods of policy comparison and empirical analysis to analyze and summarize the adjustment ideas and implementation effect of the financing policy for individual accounts of medical insurance in the municipal level reform.Results Under the principle of minimizing policy changes,S City has fully balanced the policy differences in each areas,and its reform practices have a certain reference significance;however,the problems such as the structure imbalance of the individual accounts of medical insurance for urban workers and excessive fund balances remain to be solved.Conclusion It is suggested that continue to steadily reduce the proportion of individual accounts for employed workers,improve the method of individual accounts for retirees,further adjust and optimize the financing structure of local supplementary medical insurance funds,and continue to promote the transition from individual accounts to outpatient pooling fund.

关 键 词：基本医疗保险 市级统筹 城镇职工医保个人账户 筹资 

分 类 号：R19[医药卫生—卫生事业管理]