【作者】 田源；

【导师】 唐金成；

【作者基本信息】 广西大学 ， 国民经济学， 2017， 硕士

【摘要】 在我国经济社会日益发达的今天,人民群众对于个人健康生活的诉求不断提高,然而我国现有的基本医疗保险的覆盖范围和保障水平相对有限。对于罹患重大疾病的人民群众,自身往往需要负担较大比例的医疗费用,因病致贫和返贫现象时有发生。这违背了我国到2020年解决贫困问题和全面建成小康社会的总体部署。在此背景下,我国于2012年开始全面推进大病保险制度的相关建设,目前已在全国所有省区和直辖市开展试点,且部分地区已经全面铺开相关工作。但在实际操作中,缺乏相关理论指导,存在诸多问题,需要尽快研究解决。基于以上原因,本文对我国的大病保险制度进行了全面研究:首先梳理了现有的相关文献;在此基础上,对我国的基本医疗保障体系和大病的概念作出界定,并从运行模式、筹资机制、保障水平、承保方式和监督管控五方面对我国大病保险制度做了论述,着重使用准公共产品理论、福利多元主义理论、公共外包理论和公共选择理论对我国的大病保险制度进行经济学属性分析;接着介绍了国内地区(湛江市、太仓市和厦门市)的大病保险制度实施背景和实施效果,从政策制定、筹资方式和保障效果等方面对其优势和不足进行分析;然后将国外医疗保险模式分为社会医疗保险模式、国家健康保险模式、储蓄医疗保险模式和商业医疗保险模式四种,并以德国、英国、新加坡和美国作为代表进行了阐述,分析其运行模式和优缺点;最后,对完善我国的大病保险制度提出了六点政策建议,分别是建立多渠道的动态筹资机制、构建大病保险信息服务平台、完善政企风险公担机制、加速医药卫生领域改革进程和增强居民预防保健意识。更多还原

【Abstract】 With the development of economy and society in China,the demands of people for personal health are increasing.However,the coverage and security level of the basic medical insurance in our country is relatively limited.For people who suffering from critical diseases,They often need to bear a larger proportion of medical expenses,that may incur poverty.It also violate the overall scheme for solving the poverty problem and constructing well-off society.Under this background,China began to construct the critical illness insurance institution in an all-round way in 2012,all provinces and municipalities have carried out at present,some have even made overall works.But in the actual operation,there are many problems because of the lack of theoretical guidance.Based on the reasons above,this paper has carried on a comprehensive research of the critical illness insurance institution in China:it reviews the existing literature at first,then it defines the basic medical security system and the concept of critical illness,It also gives a brief introduction to China’s critical illness insurance institution from five aspects:operation mode,financing mechanism,security content,insurance coverage and regulation.This paper focuses on the economic analysis of the critical illness insurance institution in China by using the theory of quasi-public goods,welfare pluralism theory,public outsourcing theory and public choice theory.Secondly,this paper introduces the background and effect of critical illness insurance institution in Zhanjiang,Taicang and Xiamen city,and analyzes the advantages and disadvantages from the aspects of policy making,financing mode and security effect.Thirdly,this paper divides the foreign medical insurance model into four types:social medical insurance mode,national health insurance mode,saving medical insurance mode and commercial medical insurance mode,then introduces Germany,Britain,Singapore and the United States who adopt these modes for represented and make analysis of their operation mode and advantages and disadvantages.At last,this paper puts forward six countermeasures and suggestions to improve the critical illness insurance institution in China,such as establishing a multi-channel financing mechanism,constructing critical illness insurance information service platform,perfecting the distribution of government and enterprises’ risk,accelerate the field of medicine and health reform process and enhance residents’ awareness of preventive health care.更多还原