新就业形态劳动者纳入职工医疗保险的现实困境与质量提升路径  

The Realistic Dilemma and Quality Improvement Path of New Employment Form Workers Being Included in Employee Medical Insurance

作　　者：崔开昌 毋璠 汪鸿柱 Cui Kaichang;Wu Fan;Wang Hongzhu(Social Security Research Center,Shanghai University of Engineering Science;School of Management,Shanghai University of Engineering Science;Faculty of Engineering,The University of New South Wales)

机构地区：[1]上海工程技术大学社会保障问题研究中心 [2]上海工程技术大学管理学院 [3]澳大利亚新南威尔士大学工程学院

出　　处：《宏观质量研究》2023年第5期73-87,共15页Journal of Macro-quality Research

基　　金：国家社会科学基金重点项目(21AGL024)的资助。

摘　　要：平台和共享经济等新就业形态逐渐成为社会不可分割的一部分,这使得劳动力市场出现大变革,并催生出大量的新就业形态劳动者,这部分人群工作强度高、流动性强,面临严峻的医疗风险和职业伤害风险。将新就业形态劳动者纳入职工医疗保险是消解其医疗风险、保障其健康权益的有效途径。党的二十大报告指出要加强灵活就业和新就业形态劳动者权益保障,尤其需要保障新就业形态劳动者的健康权益,医疗保险是保障其健康权益的基础性制度安排。基于社会质量理论,对新就业形态劳动者医疗保险的政策发展历程进行了梳理,对存在的现实困境进行了深入分析,建立了新就业形态劳动者纳入职工医保的机制框架,最后从厘清用工关系、完善筹资和待遇给付标准、优化激励机制、健全监管体系和完善配套措施五个方面着手,探究新就业形态劳动者纳入职工医疗保险的质量提升路径。New employment forms such as platforms and sharing economy have gradually become an integral part of society,which has brought about great changes in the labor market and given birth to a large number of new employment forms of workers,who have high work intensity and strong mobility,and face severe medical risks and occupational injury risks.It is an effective way to remove the medical risk and protect the health rights and interests of the new employment form workers to include them in the employee medical insurance.The report of the 20th National Congress of the CPC points out that it is necessary to strengthen the protection of the rights and interests of workers in flexible employment and new employment forms,especially to protect the health rights and interests of workers in new employment forms,and medical insurance is the basic institutional arrangement to protect their health rights and interests.Based on the theory of social quality,this paper sorts out the policy development process of medical insurance for workers with new employment forms,makes an in-depth analysis of the existing practical difficulties,and establishes a mechanism framework for workers with new employment forms to be included in employee medical insurance.Finally,from the five aspects of clarifying the employment relationship,improving the financing and payment standards,optimizing the incentive mechanism,improving the supervision system and improving the supporting measures,the paper explores the quality improvement path for the new employment form of workers to be included in the employee medical insurance.

关 键 词：新就业形态劳动者 职工医疗保险 健康权益 高质量发展 

分 类 号：F842.684[经济管理—保险] R197.1[医药卫生—卫生事业管理]