城镇居民医保与新农合医疗保险制度并轨分析——以邯郸市为例-analysis on the integration of urban residents medical insurance and new rural cooperative medical insurance system —— taking handan city as an example.docxVIP

I I 摘 要 伴随着新农村合作医疗保险制度与城镇居民医疗保险制度的相继实施和不断完善， 我国基本实现了人人享受医疗保险的基本社会保障目标。然而，受我国城乡二元社会结 构和经济发展不平衡性的制约，我国现行的医疗保险制度在覆盖人群、筹资标准、保障 待遇等方面都都存在明显差距。更为重要的，随着我国社会经济的不断发展和新型城镇 化步伐的加快，城乡界限逐渐变得模糊，城乡分割的医疗保险制度弊端逐渐显现，尤其 是城镇居民医保与新农合，在并立运行的过程暴露出制度设计欠妥、管理体制混乱、服 务差异明显、医疗资源浪费等诸多问题。两制并存的格局已然不能很好的适应社会经济 发展和群众医疗需求。同时，考虑到群众需求强烈、政府财力增强、征缴主体相似等现 实情况，使我们有可能、有条件、有必要在打破城乡二元户籍制度界限、完善医疗保险 政策，理顺管理体制的基础上，通过改革参保模式，整合筹资标准，完善补偿方案，健 全信息平台，统一基本用药目录等措施逐步探索、推进新农合与城镇居民医疗保险的并 轨以及城乡医疗保险一体化，为解决医疗保障城乡分立日益凸显的矛盾，促进城乡医疗 卫生资源的合理配置，实现医保制度公平，进而为解除人员流动的后顾之忧，推动城乡 建设一体化和经济社会发展提供坚实可靠的社会保障。 关键词 新农合 城镇居民 医疗保险 居民医保 并轨 II II Abstract Abstract These years, the New-type Rural Cooperative Medical System and the Urban Social Medical Insurance System have been implemented and improved one after the other. With the developing of them, we’ve achieved the goal of the social security basically that everyone in China can be the beneficiary of the medical insurance. The dual economic developments between urban and rural, however, are not balanced. Because of its constraints, there are a number of gaps in the current medical insurance system, including the coverage, financing standard, security, etc.More importantly, nowadays, the social economy and the new-type urbanization have developed faster and faster. As a result, the boundaries between urban and rural have been blurred gradually. Naturally, the malpractice of medical insurance systems between urban and rural is gradually emerging. It is especially reflected in the New-type Rural Cooperative Medical System and the Urban Social Medical Insurance System. They run together and plenty of problems are being exposed in the design of the system, the management system, the differences of the service in different places and the waste of medical resources. Obviously, the pattern of the coexistence of the two systems can be adapted to neither the development the society and the economy nor the needs of the masses’ health. Meanwhile, the masses’ needs are becoming stronger and stronger, t