中国实现全民医保的政策基础和制度创新  

Policy Foundations and Institutional Innovationsfor Realizing Universal Health Care Coverage in China

作　　者：杨燕绥 秦勤[2] 杨永恒[2] YANG Yan-sui;QIN Qin;YANG Yong-heng(Institute of Hospital Management,Tsinghua University,Shenzhen Guangdong 518071,China;School of Public Administration,Tsinghua University,Beijing 100084,China)

机构地区：[1]清华大学医院管理研究院,广东深圳518071 [2]清华大学公共管理学院,北京100084

出　　处：《苏州大学学报(哲学社会科学版)》2025年第1期44-55,共12页Journal of Soochow University(Philosophy & Social Science Edition)

基　　金：国家社会科学基金重大项目“实现积极老龄化的公共政策及其机制研究”(项目编号:17ZDA121)的阶段性成果。

摘　　要：2003年中国城镇化率不足40%,如何引导9亿多农村居民步入社会医疗保险,逐步整合了城乡居民社会医疗保险,并实现农村居民异地就医和即时结算,这是一个全球未有的创举,源自中国共产党实现全民医疗保障的政治承诺和中国政府与社会的制度创新,并得到国际社会的认同。首先,基于文献综述构建研究架构,以解释中国共产党以人民健康为中心实现全民医疗保障的政策基础,以及中国政府和社会基于中国国情,对农村居民实施激励性筹资、职工居民分步走的制度创新和综合治理能力。其次,从健康、消费和满意度三个维度进行了定量分析,验证其良好的社会效应,从而丰富了公共选择的理论和实践。最后,根据党的二十届三中全会报告关于“尽力而为”的精神,以医疗集团二次分配和职工医保个人账户家庭共用为例,展望了居民医保制度克服筹资难题和与职工医保逐渐整合的持续发展路径。In 2003,China’s urbanization rate was less than 40%,the questions of how to guide more than 900 million rural residents to step into social health insurance,gradually integrate urban and rural residents’social health insurance,and realize off-site medical care and instant settlement for rural residents become a globally unprecedented initiative,which originates from the political commitment of the Communist Party of China to realize universal health care coverage and the institutional innovation of the Chinese government and society,and has been recognized by the international community.First,the research framework is constructed based on the literature review to explain the policy foundation of the CPC to realize universal healthcare coverage centered on people’s health,and the institutional innovation and comprehensive governance capacity of the Chinese government and society to implement incentive financing for rural residents and step-by-step approach for workers based on China’s national conditions.Secondly,quantitative analysis is conducted in three dimensions of health,consumption and satisfaction to verify its good social effects,thus enriching the theory and practice of public choice.Finally,according to the spirit of the report of the Third Plenary Session of the 20th Central Committee of the Communist Party of China on“doing the best we can”,and taking the examples of the secondary distribution of medical groups and the household sharing of individual accounts of employee health insurance,we look forward to the path of sustainable development of the residents’health insurance system in order to overcome the difficulties of financing and the gradual integration of the system with that of the employees’health insurance.

关 键 词：政治承诺 制度创新 全民医保 居民医保 

分 类 号：C916[经济管理]