新型农村合作医疗向社会基本医疗保险制度过渡路径探究——以东莞市为例.pdf

新型农村合作医疗向社会基本医疗保险制度过渡路径研究——以东莞市为例 摘 要 摘 要 新型农村合作医疗制度是由政府组织、引导、支持,农民自愿参加,个人、集体 和政府多方筹资, 以大病统筹为主的农民医疗互助共济制度。该项制度自2003 年以 来已经运行了10 年，基本实现了农村居民全覆盖的目标，有效地减轻的农民的医 疗费用负担，减少了“因病致贫、因病返贫”现象。但制度本身也存在的诸多缺 陷导致制度在运行中存在了诸多问题：基金安全性不高、“逆向选择”难以消除、 保障水平低下等。本文以正义论、公共产品理论、制度变迁理论为理论基础，在 界定新农合与社会基本医疗保险内涵的基础上，系统分析新农合运行十年来取得 的成就与存在的不足。同时以东莞市社会基本医疗保险模式为个案，提出新农合 未来应实现与城镇职工基本医疗保险、城镇居民基本医疗保险并轨，构建统一的 社会基本医疗保险，实现用一种制度覆盖全体居民，真正实现人人享有基本医疗 保障。 关键词：新型农村合作医疗 社会基本医疗保险 卫生正义 制度衔接 作 者：蔡滨 指导老师：王俊华教授 I 英文摘要 新型农村合作医疗向社会基本医疗保险制度过渡路径研究——以东莞市为例 Research on Transition Path of the New Type of Rural Cooperative Medical Care to the Social Basic Medical Insurance System ——Take Dongguan as an Example Abstract The new type of rural cooperative medical care system can be defined as a system organized, guided and supported by the government and farmers can voluntarily choose to participate in it or not. It is financed by multi-party, includes the individual, collective and government, which mainly focuses on serious illness co-ordination, based on a principle of farmer mutual aid union. This system has been run for a decade since 2003, has basically achieved the goal of full coverage of rural residents, effectively eliminate the burden of health care costs, reduce the phenomenon of illness causing poverty and returning to poverty due to illness. However, the system itself has some drawbacks which create many problems during operation, such as low level of fund security, difficulty to erase adverse selection and poor results of protection. The theory of justice, institutional change and public goods theory are