职工基本医疗保险制度改革中保方和患者之间关系研究  

A study on the relationship between insurer and insured in the reformation of medical insurance system for staff and workers

作　　者：袁杰[1] 杨达[2] 

机构地区：[1]江西中医学院,330006 [2]江西省社会科学院,330006

出　　处：《中国卫生资源》1999年第5期38-40,共3页Chinese Health Resources

摘　　要：该文分析了职工基本医疗保险制度改革中，保险方和患者之间的既矛盾又统一的关系。职工医疗保险方代表和保护患者的利益，患者利益需要职工医疗保险方保障，保方和患者的关系是统一的；但是，保方的利益容易受到患者的侵害，职工医疗保险方制定的政策也会影响到部分人群的利益，保方和患者之间也存在一定的矛盾。提出科学制订新方案的实施细则，靠政策引导患者医疗行为，使保方和患者的目标一致。The paper analyzed the contradictory and united relationship between the insurer and insured. On the one hand, the insurer represents and safeguards the insured’interests, on the other hand, the insured often damage the insurer’s interests. In order to resolve their contradiction and get to a common objective, a new policy was suggested to guide the insured’medical behavior.

关 键 词：职工基本医疗保险制度 改革 患者 保险方 中国 

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]