我国社会医疗保险和商业医疗保险协调发展研究.pdf

摘要 医疗保障制度是社会保障制度的重要组成部分，它对国民健康以及经济和 社会发展有着重要作用，是国家的基本经济社会制度之一。社会医疗保险与商 业医疗保险在维持社会稳定、弥补经济损失方面共同发挥着作用，同时又有所 区别。在许多国家的医疗保障体系中，社会医疗保险和商业医疗保险起着相辅 相佐，互为补充的作用。我国社会医疗保险遵循保基本、广覆盖的原则，主要 提供基本医疗保险，难以满足人们对不同层次医疗服务的需求，建立健全多层 次医疗保障的需求日益迫切，所以要更好地促进社会医疗保险和商业医疗保险 的发展，社会医疗保险和商业医疗保险有机结合、协调发展成为医疗保障的必 然发展趋势。 我国社会医疗保险与商业医疗保险协调发展是由我国的国情、国力决定 的。我国是发展中国家，人口多、底子薄、财政困难、企业效率不高，所以为 了使医疗保险既能发挥保障生活和安定社会的作用，又能适应不同经济条件下 的具体需要，宜实行多种保障模式。 本篇论文对现阶段我国社会医疗保险与商业医疗保险合作开展业务的新 现象以协调发展的视角来总结分析，从理论及现实两方面探讨了其存在发展的 必要性和可行性，结合国外的先进经验从政府及商业保险公司两方面分析了其 发展的制约因素，进而针对这些阻力提出了相应的对策。 【关键词】社会医疗保险 商业医疗保险 协调发展 3 Abstract The medical security insurance, a very important part of the social security system, plays a great role both to the people’s health and the social and economic development of the country, so it has been one of the basic social and economic systems. Social medical insurance can keep social stability and make up for economic damage just like the commercial insurance. Though they can complement each other in many countries, they still have many differences. Chinese social medical insurance abides a rule which has a low level and covers an extensive sector. So it can only provide a basic medical insurance, but it is hard to meet the people’s medical needs in a different level. So now there is an increasing requirement for the establishment of a multi-level medical security insurance. And the combination and the coordination of the social medical and the commercial insurance has become an inexorable trend for the development of the social medical insurance. Their coordinated development has to be decided by China’s actual conditions and her national power,