健全医保待遇保障机制的实践与思考——以宁德市为例  

Practice and Reflections on Improving the Guarantee Mechanism of Healthcare Security Benefits--Taking Ningde City as an Example

作　　者：吴健 

机构地区：[1]福建省宁德市医疗保障局,宁德352000

出　　处：《中国医疗保险》2023年第11期93-97,共5页China Health Insurance

摘　　要：为持续破解人民群众看病难、看病贵问题,我国建成了全世界最大的全民基本医疗保障网,但医疗保障发展不平衡不充分问题已成为制约医疗保障高质量发展、保障人民健康、促进共同富裕的瓶颈所在。这其中,如何健全完善基本医保待遇保障机制,促进医疗保障待遇制度法定化、决策科学化、管理规范化,是解决医疗保障发展不平衡不充分问题的关键抓手,也是更好实现减轻群众就医负担、增进民生福祉、维护社会和谐稳定目标的重要基石。本文结合近年来宁德市基本医保待遇保障工作方面的探索实践,围绕医疗保障待遇“三化”目标,就健全完善医保待遇保障机制进行探讨。In order to continuously solve the issue of affordability and accessibility to medical care service,China has established the world's largest universal basic healthcare security network,however,the unbalanced and insufficient development of healthcare security has become the bottleneck of the high-quality development of healthcare security,people's health and common prosperity.Among them,how to perfect the guarantee mechanism of benefits,and promote the legalization,scientific decision-making,and standardized management of healthcare security benefits system is the key to the problem of unbalanced and inadequate development of healthcare care.Also,it is the important foundation for better achieving the goal of reducing the burden of medical services for the people,improving people's well-being and maintaining social harmony and stability.In this paper,we review the practice of basic medical insurance benefits of Ningde City in recent years,and discuss how to perfect the guarantee mechanism of benefits around the goal of“Three changes”.

关 键 词：制度法定化 决策科学化 管理规范化 待遇保障机制 

分 类 号：F840.684[经济管理—保险] C913.7[社会学]