xx市城鄉(xiāng)一體化醫(yī)療保險(xiǎn)制度研究

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目 錄
第1章 緒論 1
1.1研究背景 1
1.2研究目的和意義 2
1.2.1研究目的 2
1.2.2研究意義 2
1.3國(guó)內(nèi)外研究綜述 2
1.3.1國(guó)外研究綜述 2
1.3.2國(guó)內(nèi)研究綜述 3
第2章 基本概念及相關(guān)理論 4
2.1相關(guān)基本概念 4
2.1.1醫(yī)療保險(xiǎn)制度 4
2.1.2城鄉(xiāng)概念 5
2.2相關(guān)理論 5
2.2.1社會(huì)公平理論 5
2.2.2 公共服務(wù)理論 6
第3章 天津市城鄉(xiāng)一體化醫(yī)療制度現(xiàn)狀分析 6
3.1基本情況 6
3.1.1城鄉(xiāng)一體化醫(yī)保背景 6
3.1.2城鄉(xiāng)一體化醫(yī)保實(shí)施情況 7
3.1.3城鄉(xiāng)一體化醫(yī)保運(yùn)行管理 10
3.2存在的問(wèn)題 11
3.2.1參保率增長(zhǎng)緩慢 11
3.2.2籌資標(biāo)準(zhǔn)偏低 11
3.2.3相比城鎮(zhèn)職工參保待遇不足 12
3.3存在問(wèn)題的原因分析 13
3.3.1少數(shù)人群參保意識(shí)淡薄 13
3.3.2政府衛(wèi)生費(fèi)用支出不足 13
3.3.3醫(yī)保費(fèi)用來(lái)源單一 14
第4章 城鄉(xiāng)一體化制度國(guó)外實(shí)踐及借鑒 14
4.1國(guó)外實(shí)踐概況 14
4.1.1 英國(guó) 14
4.1.2 德國(guó) 14
4.1.3 美國(guó) 15
4.2借鑒意義 15
4.2.1 醫(yī)保發(fā)展需要政府支持 15
4.2.2 統(tǒng)籌多層次發(fā)展 15
4.2.3 發(fā)揮市場(chǎng)機(jī)制作用 16
第5章 完善天津市城鄉(xiāng)一體化醫(yī)保的對(duì)策 16
5.1 加大政府支持 16
5.1.1 針對(duì)性的宣傳和管理 16
5.1.2由自愿性向強(qiáng)制性轉(zhuǎn)變 17
5.2 探索與城鎮(zhèn)職工醫(yī)療制度的銜接 17
5.2.1縮小兩者差距 17
5.2.2推進(jìn)制度融合 17
5.3 引入市場(chǎng)機(jī)制 18
結(jié)論 18
致謝 19
參考文獻(xiàn) 20

摘要 天津市于2010年對(duì)新型農(nóng)村合作醫(yī)療保險(xiǎn)和城鎮(zhèn)居民基本醫(yī)療保險(xiǎn)進(jìn)行整合，建立起城鄉(xiāng)一體化醫(yī)療保險(xiǎn)。近年來(lái)，隨著相關(guān)機(jī)構(gòu)對(duì)其不斷完善，城鄉(xiāng)一體化醫(yī)療制度總體呈發(fā)展趨勢(shì)，但由于醫(yī)療制度自身存在復(fù)雜性，加之國(guó)內(nèi)沒(méi)有經(jīng)驗(yàn)借鑒，制度的發(fā)展面臨挑戰(zhàn)。本文運(yùn)用文獻(xiàn)分析法、比較分析法等方法對(duì)天津市城鄉(xiāng)一體化醫(yī)療制度進(jìn)行研究。首先對(duì)天津市的經(jīng)濟(jì)現(xiàn)狀和醫(yī)保制度實(shí)行情況進(jìn)行分析，提出天津市城鄉(xiāng)一體化醫(yī)療保險(xiǎn)存在參保率增長(zhǎng)緩慢、參保待遇不足、缺乏政府財(cái)政支持等問(wèn)題。其次，介紹了三個(gè)不同醫(yī)療保障制度代表國(guó)家的情況，分析成功經(jīng)驗(yàn)是依靠政府支持、建立多元化醫(yī)療制度、利用市場(chǎng)機(jī)制作用。最后，借鑒國(guó)外經(jīng)驗(yàn)，針對(duì)天津市的具體情況，提出加大政府支持力度、研究與城鎮(zhèn)職工醫(yī)療保險(xiǎn)銜接、適當(dāng)引入市場(chǎng)機(jī)制等建議。希望通過(guò)本次研究，能夠?yàn)樘旖蚴幸惑w化醫(yī)療保障制度的發(fā)展提供依據(jù)，促進(jìn)其發(fā)展完善，為居民提供更全面更深層次的保障。
關(guān)鍵詞： 城鄉(xiāng)一體化 醫(yī)療保險(xiǎn)制度 參保率


Research on integration of urban and rural medical insurance system in Tianjin
Abstract In response to the national policy requirements for balancing the urban and rural development , Tianjin has integrated the new rural cooperative medical insurance and Urban Residents Basic Medical Insurance .since 2010, established the integration of urban and rural areas medical insurance ,insure rates ncreased year by year, basically achieved universal coverage. In recent years,with the constant improvement of the system by related organizations,the developments of integration of urban and rural areas medical system are the general trend .However,it faces the challenges due to the complexity of the medical system and callowness of domestic system. This thesis uses literature analysis method, comparative analysis method, system analysis method and other methods to research the integration of urban and rural medical system of Tianjin. Firstly,it analyzes Tianjin’s current condition of economy and the implementation status of medical insurance system, raises the problems about the slow increase of insure rate , the deficiency of insurance welfare and the lack of government financial support,etc. Secondly,it introduces the situation of three countries ,which stand for different medical insurance systems ,and analyzes their successful experiences.Finally, it learns from foreign experiences,points at the specific situation of Tianjin ,gives the advises on strengthening the government support,associating the research with the medical insurance for urban workers and appropriately introducing market mechanism,etc. Through this research,I hope that provide the gist for the development of integration of medical security system of Tianjin, promote the deep development and provide more comprehensive and deeper security for residents.

Key words ntegration ofurban and rural  medical insurance system Insurance rates