【作者】 杨新民；

【导师】 邓子基；

【作者基本信息】 厦门大学 ， 财政学， 2005， 博士

【摘要】 从我国目前的经济发展和社会发展状况看,大部分民众基本上解决了温饱问题。按照马斯洛的需求理论,在解决了生存问题之后,健康需求就会排在主要位置,成为人们的首要需求。我国1998年之后所进行的医疗保险体系改革,其对象只是涵盖了城镇职工;一度实行的农村居民合作医疗制度因失去了赖以存在的集体经济基础而处于崩溃的边缘。按照公共财政的要求,为社会公众提供基本的医疗保险服务是政府的职责所在。因此,本论文针对我国现存的二元经济结构和二元社会结构,结合我国经济和社会发展水平,探讨应该如何设计具有中国特色的医疗保险制度,以满足社会公众“病有所医”的公共需求。全文共分7章:第1章是导论,主要介绍了本文研究的背景、主要目标、选题的意义、采用的研究方法和创新与不足。第2章是医疗保险的理论基础。论文分析了西方社会保障理论的发展历史,认为有多种理论可作为社会保障的理论基础,但从医疗保险制度本身的特点和运行模式出发,公共产品理论和福利经济学是医疗保险制度分析的理论基础。第3章是医疗保险的历史分析和国际比较。这一章首先分析了我国古代的医疗保险制度的发展和演变,认为政府在医疗保险中应该发挥主要作用,而民间救助则是政府医疗的重要辅助。接下来分析了其他国家的医疗保险制度,从资金来源、管理模式和支付模式对四种典型的医疗保险模式进行了简单比较分析,认为四种模式既有共性,又各有其优势和缺陷。第4章分析了我国的二元经济结构、二元社会机构和二元医疗保险制度。文章首先对二元经济结构和二元社会结构在我国的具体表现进行了分析,总更多还原

【Abstract】 In accordance with the present economic and social development, most people are able to dress warmly and ear theirs fill. Maslow’s Demand Theory indicates that health would become the most significant demand for public after resolving the surviving problem. After 1998, China government implements the reformation of medicinal insurance system, which yet only applies for urban residents. Along with the downfall of Collective Economy, cooperative medicinal system for rural residents collapsed gradually as it lost the economic basis that was ever depended on. The public finance requires that government should be obligated to provide the basic medicinal insurance for public. Therefore, this dissertation, focusing on the existing dual economy and dual social structure, will integrate the status of economic development and social development in China and discuss how to design Chinese medicinal insurance system so that publics are able to have medical treatment.This dissertation is divided into seven chapters, as follows: Chapter One is introduction, which includes background, main target, meaning of the topic and methodology.Chapter Two explains academic frameworks of medicinal insurance. It suggests the development of social security theory in west countries and figures several theories, which is regarded as academic foundation of social security. However, both public goods theory and welfare economy are academic frameworks of medicinal insurance system in accordance with its characteristics and operational model.Chapter Three reviews history of medicinal insurance and make horizontal更多还原