中国基本医疗保险适度缴费率模型及测算.docVIP

中国基本医疗保险适度缴费率模型及测算摘 要:基本医疗保险缴费率是指一定时期(通常为一个月)基本医疗保险参与者为被保险人所缴纳的基本医疗保险费占工资的比重。基本医疗保险适度缴费率要与基本医疗保险的功能相适应,也就是要有利于保障人口的基本医疗安全,要与经济发展水平相适应,要有利于资源的充分利用和资源的优化配置。这是从需求、供给和经济效率角度对基本医疗保险缴费率的适度性判定。从国民收入再分配体系和劳动力供求体系的角度构建了基本医疗保险适度缴费率模型。根据模型对基本医疗保险适度缴费率做了测算,提出了基本医疗保险缴费率适度发展的政策选择。 关键词:基本医疗保险;缴费率;个人账户;共保率;道德风险 中图分类号:F842.684 文献标识码:A 文章编号:1003-5192(2010)01-0054-06 Model and Calculation on the Optimum Premium Rateof Basic Medical Insurance in China JIA Hong-bo (Public Administration School of Beijing University of Aeronautics and Astronautics, Beijing 100191, China) Abstract:Premium rate of basic medical insurance refers to the proportion between premiums of basic medical insurance that participant pays for insurant and employee?s wage in one period (generally a month). The optimum premium rate of basic medical insurance should adapt to the basic function of basic medical insurance, namely it must guarantee the people? basic medical security, adapt to the economic development and contribute to the fully use and optimum allocation of resource. This is the optimum estimation to the premium rate of basic medical insurance from the demand, supply and economic efficiency aspect. The optimum premium rate model of basic medical insurance is constructed by national income redistribution system and labor force demand and supply system. Furthermore, this model provides a measuring of the optimum premium rate of basic medical insurance and gives the policy implications to optimum development of the premium rate of basic medical insurance. Key words:basic medical insurance; premium rate; individual account; coinsurance rate; moral hazard 1 引言 2007年7月10日,国家颁布了《国务院关于开展城镇居民基本医疗保险试点的指导意见》,要求把不属于城镇职工基本医疗保险制度覆盖范围的非从业城镇居民纳入城镇居民基本医疗保险。而且,该意见要求在完善城镇居民基本医疗保险制度时要考虑居民家庭和财政的负担能力,恰当确定筹资水平,探索建立筹资水平、缴费年限和待遇水平相挂钩的机制。这是继1998年《国务院关于建立城镇职工基本医疗保险制度的决定》以后进一步完善基本医疗保险制度的重要措施之一。 在基本医疗保险覆盖面从城镇职工扩大到城镇居民的情况下,确立基本医疗保险适度缴费率变得十分紧迫和必要,因为基本医疗保险适度缴费率在一定程度上决定了参保患者可用于报销的基本医疗费用,有助于遏制不合理的医疗消费和医疗费用,对于保证