【作者】 杨萍；

【导师】 朱秋莲；

【作者基本信息】 湖南师范大学 ， 社会保障， 2011， 硕士

【副题名】以湖南省澧县为例

【摘要】 医疗保险是与人民生活息息相关的,建立起覆盖全体城乡居民的医疗保险制度,提高我国全体国民的健康水平是我国医疗卫生领域最为迫切的任务,也是社会公共服务均等化、公平化的最好的体现。随着“让人人享有基本医疗服务,建立覆盖全国城乡的医疗保险体系”这一目标的确立以及“全民医保”制度的推进,有中国特色的基本医疗保险体系已经基本完成,形成了制度层面的“全民医保”,城镇职工基本医疗保险制度、城镇居民医疗保险制度和新型农村合作医疗保险制度构成了我国的基本医疗保险体系,建立起保障人民医疗水平的安全网。但从长远的发展来看,目前的制度体系的科学性和公平性、实施的有效性依然是各个领域关注的热点,要实现人人享有基本医疗服务,实现全民医保的自标,必须要对目前的医疗保险制度进行整合、调整和再造,以此来真正实现医疗服务的城乡均等化、公平化。整合城镇居民基本医疗保险制度和新型农村合作医疗制度,将二者合并为一体,与城镇职工医疗保险构成二元化的医疗保障体系是大部分地区选择的路径。但是在这个过程中,面临着许多的问题,统筹层次、筹资标准不一致,信息资源不共享,法律政策不一致,医疗待遇的不公等等。本文遵循认识问题、分析问题、解决问题的思路,以城镇居民基本医疗保险和新型农村合作医疗保险为研究对象,以罗尔斯的公平正义理论和二元经济结构理论为指导,以湖南省澧县为例,分析了以非从业居民为保障对象的城镇居民医疗保险和新型农村合作医疗保险二者之间存在的差距及其原因,探索了建立城乡一体化的基本医疗保险制度的一系列对策。研究表明：目前我国城乡医疗保险差距明显。政府与社会应该从户籍改革、制度并轨、统筹城乡经济发展、加强法制建设、制度宣传和政府支持等方面实现政策联动,互为补充,形成合力,加快推进城乡医疗保险一体化的建设。更多还原

【Abstract】 Health insurance is with the people’s life, set up to cover all of the medical insurance system for urban and rural residents, improve all our country national health level of medical field is the most urgent task, but also it is the best embodiment of a social equal and fairness public services. To establish this goal about "let everyone will have access to basic medical service, building urban and rural health insurance covering the whole system " and "universal coverage" system with Chinese characteristics, basic medical insurance system has been basically completed, formed the system level "universal coverage", the basic health insurance system for urban employees, the urban health insurance system and the new rural cooperative health insurance system constituted the basic health insurance system, set up the level of protection of people’s health care safety net. But judging from the long-term development, the effectiveness of the implementation is still the focus of attention in various fields, to achieve universal access to basic health services, to achieve the goal of universal coverage, we must integrate, adjust and recycle the health insurance system, so as to realize a equal and fair urban and rural medical service equal, fair.Integrated urban resident basic medical insurance system and the new rural cooperative medical system, will allow the two merged into one, and constitute a dual medical insurance with urban workers of the health care system is the most choice. But in the process, it is faced many problems, overall level of funding criteria are inconsistent, do not share information resources, legal policy is inconsistencies, medical treatment is injustice, etc.This follows understanding, analysis problem; problem-solving mentality, let urban resident basic health insurance and the new rural cooperative medical insurance as the research object, let rawls’s theory of justice and the dual economic structure theory as the guide, let Lixian of hunan province as an example, this paper analyzes the gap of urban residents medical insurance for non-employed residents, and the new rural cooperative medical insurance between and its reason, explore the urban-rural integration system of insurance of primary health treatment of a series of countermeasures.Research shows that:the disparity between urban and rural medical insurance in China. The government and society should realize policy linkage, complementary, and form a cohesive force, acelerating the construction of the integration of urban and rural medical insurance from the reform of the household registration, system axle, coordination of urban, rural economic development and government support, and strengthening the legal system construction and system publicity.更多还原