深化“三项”基本社会医疗保险制度改革探讨.docVIP

深化“三项”基本社会医疗保险制度改革探讨 通过近10年的逐步建设，与中国特色 社会主义市场经济体制相适应的“三项”基本社会医 疗保险制度，在解决社会矛盾、促进城乡公共卫生事 业发展和均等化方面发挥了积极作用，也一定程度体 现了全体国民分享经济发展成果机制的初步建立。但 目前的“三项”基本社会医疗保险制度仍存在不公平 问题、管理体制问题、“碎片化”问题等，医疗服务机 构也需深化改革。应开展城乡社会医疗保险一体化的 试点工作，将“三项”合并“两项”，并针对特殊嗜好 开征相应的税收，现实社会医疗保险筹资和待遇的公 平享受；实施“碎片”整理，深化医疗服务机构改革。 关键词：“三项”基本医疗保险；企业职工社会医 疗保险；城镇居民社会医疗保险；新型农村合作医疗 保险；全民医保；医疗公平；医药分离 F840.684 A : 1674-8131 (2011) 05-0044-06 On Reform of Three Basic Social Medical Insurance System WANG Fei-yue (School of Public Administration, Guizhou College of Finance and Economics, Guiyang 550004, China) Abstract: After almost ten years construction, three basic social medical insurance system fitting for market economy system of socialism with Chinese characteristics plays an active role in solving economic and social contradiction, boosting urban and rural public health cause development and equalization and so on, meanwhile, to some extent, embodies the initial setup of the mechanism for all Chinese citizens to share economic development results. Currently, however, the three basic social medical insurance system still has the problems in equalization, management system, decentralized supply and so on, and medical service agencies urgently need reform. China should start pilot work for urban and rural integrated social medical insurance, combine three into two, impose related tax according to special demand, let all Chinese fairly enjoy social medical insurance service and treatment, realize management system reform for decentralized service, and deepen the reform of medical service agencies.. Key words: three basic medical insurance; social medical insurance of enterprise employees; social medical insurance of urban residents; new rural cooperative medical insurance; medical insurance for all Chinese; medical equalization; separation of medical treatment from medicine 改革开放以来，伴随我国经济体制的不断深化改 革，社会主义市场经济的日益完善，关系到国民医疗 和健康的医疗卫生事业，也从计划经济体制下的“公 费医疗”转轨为与市场经济相适应的社会医疗保险体 系。从企业职工社会医疗保险制度到城镇居民社会医 疗保险制度，再到新型农村合作医疗保险制度的建立 （统称为“三