共同富裕背景下医疗保障的公平性:以职工医保为例  

The Equity of Social Health Insurance under the background of Common Prosperity:With Employed Workers'Health Insurance as an Example

作　　者：王震[1] Wang Zhen

机构地区：[1]中国社会科学院经济研究所,北京100836

出　　处：《复印报刊资料（社会保障制度）》2022年第9期55-68,共14页SOCIAL SECURITY SYSTEM

摘　　要：我国医保基金在筹资负担、待遇、基金结余上存在明显的地区间差距。建立全国统一的基金调剂机制是完善医保制度的必然要求,也是促进共同富裕的重大举措。本文基于社会保险的两个公平性原则,以职工医保基金为例,对基金区域差距的公平性进行了分析,并以基金收入与支出的公平性为基准估计了区域间的基金调剂比例。在基金支出方面,考虑不同地区医疗价格效应及参保人年龄结构效应,符合横向公平原则的预测基金支出分布的基尼系数比实际基金分布的基尼系数低9.22%。在基金收入方面,符合纵向公平原则的基金收入分布的基尼系数比实际基金收入的基尼系数高20.55%。在符合公平原则的基金支出及基金收入的基础上,本文还估计了相应的基金调剂额及调剂比例。There are apparent regional disparities in financing burden,benefit package and fund surplus of China's social health insurance,which is inconsistent with the principle of the common prosperity.It is necessary to resolve the regional disparity by building national fund adjustment mechanism.This paper attempts to analyze the equity of regional disparity of China's employed workers'health insurance from the two equity principles of social insurance,and to estimate adjustment proportions among different provinces based on the horizontal and vertical equity principles.The estimated Gini coefficient for regional fund expenditure consistent with horizontal equity is 9.22%lower than the actual Gini coefficient.The estimated Gini coefficient for regional fund financing consistent with vertical equity is 20.55%higher than the actual Gini coefficient.Based on the estimated fund expenditure and financing distribution among different provinces,the paper also calculates the proportion of fund for adjustment.

关 键 词：纵向公平 横向公平 基金差距 基金调剂 

分 类 号：R197.1[医药卫生—卫生事业管理] F842.684[医药卫生—公共卫生与预防医学]