摘要
公立医疗保险的根本目的,在于汇集民众的医疗费用,分摊患者医药费用的风险。医保基金当年筹集的大部分参保费应该用于支付参保者当年的防病、看病、治病。然而,很多地方城乡医保基金的结余额过高,参保者无法享受到适当的医疗保障。就全国而言,新农合基金当年结余率逐年下降,2004年是40.3%,到2008年已经下降到了15.6%,接近于"新医改方案"提出的15%指标。城镇居民医保和城镇职工医保基金2008年的当年结余率分别高达58.8%和30.0%,而累计结余更多,不少省份城镇基本医疗保险基金的累计结余可以支付30多个月。公立医疗保险基金大量沉淀下来,是极大的浪费。无论是从目前"扩内需、保增长、调结构、重民生"的短期需求来看,还是从健全医疗保障体系的长期目标来看,降低城乡医保基金的结余率都刻不容缓。
The fundamental purpose of public healthcare insurance programs is to pool citizen＇s medical funding and distribute expense risks of patients.Generally speaking,most of funding is used to pay for enrollees＇ healthcare bills.In China,however,public healthcare insurance programs record large amount of balance in many localities,so that enrollees can not enjoy adequate healthcare security they deserve.In the new rural cooperative medical schemes,40.3% of funding was not spent out in 2004,and this figure declined to 15.6% in 2008.Urban residents＇ healthcare insurance and employees＇ healthcare insurance recorded 58.8% and 30.0% of balance rate respectively in 2008.The amount of accumulated balance in urban public healthcare insurance programs can afford payment of more than 30 months. The accumulation of large funding in balance is meaningless and wasteful.How to maintain an adequate amount in balance and thereby to deliver an adequate health security for enrollees has become one of targets of new health reforms in China.
出处
《中国社会科学院研究生院学报》
CSSCI
北大核心
2010年第5期53-61,共9页
Journal of Graduate School of Chinese Academy of Social Sciences
基金
北京大学"985工程"(2004~2007)建设项目"中国城镇居民基本医疗保险的可持续性发展"的支持
关键词
社会医疗保险
基金结余率
新医改方案
城镇职工医保
城镇居民医保
新农合
social health insurance
balance rate
new health reforms
urban employees＇ healthcare insurance
urban residents＇ healthcare insurance
new rural cooperative medical schemes
