【摘要】 因病致贫问题影响着我国农村地区的稳定。农村居民因病致贫的主要原因有两个:就医保障水平下降和就医经济风险急增。因此,解决农村居民因病致贫的基本思路为,控制医疗费用过快增长以降低农村居民的就医经济风险,建立和完善医疗保障体制以增加农村居民的抗就医经济风险的能力。在医疗费用得以控制的前提下,“大病统筹”保险是目前及今后一段时期内增加农村居民抗就医风险能力的可行和适宜方案。如何让基层决策者理解因病致贫问题的解决和医保(或合作医疗)紧密相连,是医保(或合作医疗)推行的现实条件。在宏观政策到位,其他条件具备情况下,也就是说一地拟实施农村居民大病统筹医疗保险时,研制科学、合理和可操作的大病统筹医疗保险方案是能否达到解决因病致贫问题的关键。其中农村居民就医经济风险分析、风险临界线界定、保险给付比测算和保险费率厘定等,是农村医疗保险方案研制中迫切需要解决的关键技术,这些技术的缺乏是我国农村医疗保险或合作医疗流于形式的技术原因。本课题组拟以上述难点和空白点作为研究重点,理论结合实际,探索研制大病统筹医疗保险方案中的关键技术和技术操作步骤。更多还原

【Abstract】 This paper presents a significance and background of researching key techniques and operative steps of rural catastrophic medical insurance(CMI)in china. It is evident that the issue of "Impoverished Residents from Sickness "has influenced the social stability in rural areas. The"Phenomenon of Impoverished Rural Residents from Sickness "was caused ty two major factors, the lack of medical security system and a higher financial risk to seek medical care services. Therefore ,the essential strategies to solve the "Phenomenon of Impoverished Rural Residents from Sickness "are to control the increasing medical expenditure and to improve the medical security system. Reseach shows that the CMI seems a practicable scheme to improve social medical security of rural residents in China. However,while a practicable CMI scheme can be made,the following key techniques should be studied and provided,such as measure of financial risk,poverty,critical standards of financial risk,definition of catastrophic threshold,contribution rate-making,and restrictive conditions,et al. These tecniques are integrated into the prototype of CMI that aims to solve the social problem of impoverished rural residents from sickness.更多还原