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城镇职工基本医疗保险支付方式探讨

Discussing the Payment System on. Primary Medical Security Cheme Among Employees in Urbqn Areas

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【作者】 马进刘云梅

【Author】 Ma Jin, Liu YumneiHarbir Mdeica] University, Harbir, PRC, 150001

【机构】 哈尔滨医科大学中国人寿保险公司海南省分公司 150001570105

【摘要】 系统地论述了建立城镇职工基本医疗保险支付方式时应遵循的一些基本原则。支付方式的建立应该考虑我国的国情;考虑目前医疗服务机构的补偿渠道与费用控制的矛盾;考虑整个社会的经济负担;考虑各种支付方式的特点;考虑预付与后付的平衡;考虑经济风险的合理分担以及管理能力。只有从根本上解决目前医疗服务机构补偿机制的不合理问题,才能创建出科学、有效的城镇职工基本医疗保险的支付方式。

【Abstract】 The paper deals with some basic principles for establishing new provider payment for urban employees primary medical insurance. It shows that we should consider the follow factors such as the situation of our country, the contradiction between the current compensation channels of medical institutions and the expenditure control, the economic burden of whole society, various payments’ charcters, the balance between prospective and retrospective components, the rational share of economic risk and administrative capacity when the payment methods are selected. Only and only if we solve the irrational problem of current compensation mechanism of medical institutions, the scientific and effective payment method for urban employees’ primary medical insurance can be set up.

  • 【文献出处】 中国卫生经济 ,Chinese Health Economics , 编辑部邮箱 ,2001年11期
  • 【分类号】F842.684
  • 【被引频次】12
  • 【下载频次】502
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