我国城乡医疗保险一体化问题研究.doc

PAGE PAGE 25 我国城乡医疗保险一体化问题研究 摘要：在“全民医保”的目标初步实现的情况下，我国现行的基本医疗保险制度“城乡分割、部门分管”所引发的一系列问题越来越受到社会的关注。党的十八大提出要“全面建成覆盖城乡居民的社会保障体系”，将城镇职工医保、新型农村合作医疗保险、城镇居民基本医疗保险这三种制度进行合并统筹管理也被正式提上了日程。本文介绍了我国三种基本医疗保险制度的概况，并针对现有问题提出了关于城乡医保一体化建设的具体实施方案：采取两步走的战略，先对城镇居民医疗保险制度和新型农村合作医疗保险制度进行整合，再考虑城乡居民医保制度和城镇职工基本医疗保险制度的统筹，最终实现一体化的城乡医保体系。本文还提出了城乡医保一体化建议，如做好异地就医结算，落实医保关系转移接续；提高医保基金统筹层次；加强医疗服务监管，实行医保的“管办分离”；国家财政加大对低保人群的补助等等。 关键词：城乡医疗保险；一体化；方案 Research on the integration of urban and rural medical insurance in China Abstract: With the initial implementation of “universal coverage of health insurance”, a series of problems, which caused by Chinas current?basic medical insurance system of division between urban and rural areas,charged by different management departments”, are attaching more and more attention from the society. The Eighteenth-Party proposed Fully completed social security system which covered all the urban and rural residents ,and the overall management of three kinds of medical insurance?systems, which contented by urban employee basic medical insurance scheme,?new rural cooperative medical insurance scheme and urban resident basic medical insurance?scheme, was formally put on the agenda. This paper introduces the general situation of Chinas three basic medical insurance systems, and puts forward a concrete?implementation plan on the integration of urban and rural medical insurance?to solve the existing problems: take two-step strategy. First, integrate the urban resident basic medical insurance scheme and the new rural cooperative medical insurance system. Second, consider overall planning the urban and rural residents’ medical insurance scheme and urban employee?basic medical insurance scheme. Finally, achieve the target of integration of urban and rural?medical insurance system. This paper also puts forward some advice about the integration of urban and rural medical insurance system, such as doing remote medical billing, implementing the transferring of medical insurance relatio