【作者】 王栋；

【导师】 彭兆祺；

【作者基本信息】 北京交通大学 ， 社会保障， 2009， 硕士

【副题名】以廊坊为例

【摘要】 在和谐新农村建设中,农村医疗保障制度的建设具有十分重要的意义。在“看病难、看病贵”的今天,农民由于医疗保障水平和平均收入水平均偏低以及医疗卫生资源匮乏等原因,“因病致贫、因病返贫”现象普遍。为此,应强化政府责任,加大财政投入,调整卫生资源布局,加快农村医疗救助制度与卫生服务体系建立,规范发展各类补充医疗保险项目,以完善农村医疗保障体系,推进和谐社会与农村建设。长期以来,我国存在着城乡二元经济结构和城乡差距,导致在城乡之间实行了不同的二元医疗保障结构,并且公共政策和资源都向城市倾斜,致使农村医疗卫生事业发展严重滞后,医疗保障制度缺失,已从原先的“合作医疗”退化为“家庭保障”;农村医疗保障制度的建设必将成为当前新农村建设的一项重要的基础性工程。本文从我国农村合作医疗制度创新的背景入手,分析了新型农村合作医疗制度推出的必然性。并以廊坊市农村医疗保险制度为个案,系统阐述了新型农村合作医疗制度的创新特点和政府在农村医疗保障中的责任回归问题:通过分析农村医疗保险作为一种公共产品的特殊属性,探讨农村医疗保险的多元化供给方式,提出在我国农村医疗保险供给严重不足的情况下,确立以政府供给为主导,市场供给和志愿事业组织供给为补充的多元化供给模式,将是完善农村医疗保险体系的必由之路。提高农民健康保障水平一直是廊坊乃至全国农村卫生工作的重点和难点,文章通过对廊坊农村一定范围的调查研究分析,探讨农村构建多层次医疗保险体系所面临的问题与阻力,并提出建议和政策主张。当前农村的合作医疗改革刚刚起步,国家在城市和农村实施不同的医疗保障制度,但是我国医疗保障的最终目标应该是城乡医疗保障一体化。阐述对城乡医疗保障一体化的内容、步骤等。同时,主张分阶段、分区域地实现城乡医疗保障的一体化:首先建立常设的医疗保障管理机构,然后进行医疗资源的城乡合理分配,最后实现医疗保障筹资的城乡一体化。更多还原

【Abstract】 In the construction of harmonious newly country, it is very important for the construction of the village medical security system.Today in "seeing a doctor difficultly, seeing a doctor expensively", it is very widespread for the villagers that " disease leads to poverty, even disease returns to poverty" , owing to the medical treatment guarantee level and the average income level is low and the medical treatment health resources is short etc. So, we should enhance the government responsibility, enlarge public finance devotion, adjust the health resources layout, speed the village medical salvage system and establish the health service system and standardize developing each kind of complement medical treatment insurance item, in order to perfect village medical treatment guarantee system, push forward the harmonious society and village construction.For a long time, our country exists the city country duality economic structure and the city country margin, leading to the city country duality medical treatment guarantee structure of dissimilarity, and the public policy and resources tilt to the city, causing after the village medical treatment health business to lag development seriously, the medical treatment guarantee system imperfection, from the original of "cooperation medical treatment" deteriorates into "the family guarantee"; The construction of the village medical treatment guarantee system will become an important foundation engineering for the village construction lately.From viewing our country village cooperation medical treatment system, this paper analyzes the inevitability of setting up the new village cooperating medical treatment system. Take the village medical treatment insurance system in Langfang as an individual case, the article systemically elaborates the innovative characteristics of the new village cooperation medical treatment system and the problem of the government’s responsibility regress in the village medical treatment.Through analyzing the village medical treatment’s special attribute insurance conduct and actions as a kind of public product, This paper studies the diversification of the study village medical treatment insurance supplies , putting forward in the our country village medical treatment insurance to supply the circumstance under the serious shortage , establishing with the government supply for predominance, the market supplies the business organization to supply for the complement with the wishes of the diversification supply mode, will be necessary way for the village medical treatment insurance system. Raising the village guarantee level has been the point and crux that in Langfang and the whole country, by the inquisition research analysis of the certain scope to village in Langfang, the article inquiries into the problems and resistance that the multi-layer medical treatment insurance system will face, and putting forward the suggestions and policy assertion. At present the cooperation medical treatment reform of the village just starts, the nation carries out the different medical treatment guarantee system in the city and the village, but our country medical treatment guarantee of the end target should be the city country medical treatment guarantee integral wholly. This paper elaborates the contents and step etc. That turns to the city country medical treatment guarantee integral whole. In the meantime, claiming to carry out the city country medical treatment guarantee of the integral whole turn at different stages and in different districts. The medical treatment guarantee was first build up often establishing management organization, then carrying on the city country reasonable allotment of the medical treatment resources, and carrying out the city country integral whole of the medical treatment guarantee money rising finally.更多还原