基本医疗保险制度变迁与国民获得感提升  

The Institutional Change of Basic Medical Insurance and the Improvement for Citizens’Sense of Gain

作　　者：贾洪波[1,2] Jia Hongbo

机构地区：[1]北京航空航天大学公共管理学院 [2]北京航空航天大学社会保障研究中心

出　　处：《社会科学辑刊》2022年第3期39-49,F0002,共12页Social Science Journal

基　　金：国家社会科学基金项目(14BRK020)。

摘　　要：自1998年以来,基本医疗保险制度经历了由制度创立阶段到三项制度并行分立阶段再到三项制度整合阶段的变迁过程。整个变迁过程呈现出类型上诱致性变迁与强制性变迁并举、路径上沿着扩大覆盖面和提高待遇支付展开、方向上趋向制度整合、速度上渐进、内容上囊括结构性改革和参数性改革等特征。与此同时,1998—2019年间,由覆盖面和报销比例共同决定的可乘效用函数衡量的国民对基本医疗保险制度的获得感也稳步提升。这种提升主要依赖于基本医疗保险报销比例的进一步提高。因此,稳步提高基本医疗保险对实际医药费用的报销比例、逐步优化基本医疗保险筹资制度、联动改革医疗和医药制度来提升基本医疗保险对医药费用的报销比例,是进一步提升国民对基本医疗保险制度的获得感的重要举措。Since 1998,the institutional change of basic medical insurance has experienced from the establishment stage to the parallelly separated stage of three systems and then to the integrated stage of three systems.The whole process shows the characteristics of induced changes and imposed changes existing simultaneously in the category,an expansion of coverage and an improvement of treatment payment along the path,an institutional integration in the direction,a gradual change in the speed,and the inclusion of structural and parametric reform in the content.From 1998 to 2019,with the institutional change of basic medical insurance system,citizens’sense of gain from the basic medical insurance system,as measured by the multipliable utility function jointly determined by coverage and reimbursement rate,has steadily improved,which mainly depends on the further improvement of the reimbursement rate for basic medical insurance.To further enhance the citizens’sense of gain from the basic medical insurance system,we should steadily increase the reimbursement rate for basic medical insurance to actual medical expenditure,gradually optimize the financial system of basic medical insurance,and coordinate policy reform of medical treatment and medicine to improve the reimbursement rate of basic medical insurance to medical expenditure.

关 键 词：基本医疗保险 制度变迁 制度变迁特征 国民获得感 

分 类 号：F842.684[经济管理—保险]