我国城乡居民基本医疗保险制度衔接的现状_问题与建议(1)

2010131夏迎秋1*景鑫亮2段沁江31.江苏省卫生厅江苏南京2100082.南京大学政府管理学院江苏南京2100933.江苏省职工医科大学江苏南京210008摘要医疗保障作为城乡居民生存和发展的基本需求,是城乡统筹发展的重要保证现行的城乡基本医疗保险制度建设取得了明显的成效,提高了城乡居民抵御疾病风险的能力,缓解了居民看病难看病贵的压力但城乡分治的医疗保险制度在推进过程中也存在着一些问题,如法律保障欠缺卫生资源分配不均制度衔接困难统筹层次低等因而,必须加强城乡医保制度尤其是城镇居民医保和新型农村合作医疗之间的制度衔接,逐步建立城乡一体化的医疗保障制度,推进城乡社会经济协调发展关键词基本医疗保险;城乡一体化;衔接;全民覆盖中图分类号:R1971文献标识码:Ado:i10.3969/.jissn.16742982.2010.01.009Statusquo,problemsandrecommendationsontheconvergenceofurbanruralbasicmedicalinsurancesysteminChinaXIAYingqiu1,JINGXinliang2,DUANQinjiang31.HealthDepartmentofJiangsuProvince,JiangsuNanjing210008,China2.SchoolofGovernment,NanjingUniversity,JiangsuNanjing210093,China3.SchoolofMedicalWorkersinJiangsuProvince,JiangsuNanjing210008,ChinaAbstractAsthebasicneedsofsurvivalanddevelopmentforurbanandruralresidents,themedicalsecurityisanessentialassuranceforbalancingbothurbanandruraldevelopmen.tThecurrentimplementationofruralandurbanbasicmedicalinsurancesystemcontinuetoincreasethecapacityagainstthefinancialriskofdiseaseforallresidents,moreorlesseasethepressureofseeingdoctorisdifficultyandexpensive.However,thesegmentationofruralandurbanmedicalinsurancehasanegativeimpactontheprocessofbalancingruralandurbanareas,forinstance,lackoflegalprotection,unevendistributionofresources,institutionalconvergencedifficulties,andlowlevelplanning.Thus,itneedstostrengthentheurbanandruralmedicalinsurancesystem,especiallytheUrbanResidentsMedicalInsuranceandthenewRuralCooperativeMedicalScheme,toestablishanintegratedurbanandruralmedicalinsurancesystem,andtopromotethecoordinateddevelopmentofurbanandruraleconomy.KeywordsBasicmedicalinsurance;Urbanruralintegration;Convergence;Universalcoverage,,,,,,,,[1],43*:,(1949),,,,Emai:[e-mail]hPolicy,January2010,Vol3No1,,,,,,,,,11.1,,,,,,,,,,,,,,,,,,,,,,,,,1.2,,,,,,,,,,,1.3,,,,,,,,,,,,,,,,2,,,,,,,,,,,442010131,[2],,30%~40%,,,,,,33.1,,,,,,,,,,,3.2,()GDP5%[3],,[4],,,3.3,,,,[5],3.4,,,,,,,,,,,,,,,,3.5,,,,,,,,4,,,4.11961,1977,19851411%,19952993%1980,,45ChineseJournalofHealthPolicy,January2010,Vol3No1,,,19869199810,,2000,2003,,,19892007,,9039%9869%[6]1950,131994,58%1985,,2005,99%,[6]4.244%,,3%~6%;,3.9%,,,,,3000,,,,,,,,,,,4.3,,,,12,,,,,,,,,,,,,,,,55.1,,[7],,,,5.2,,,,,,,462010131,,,,[8]5.3,,,[9],,,,,,,,,,,,5.4,,,,,[10],,,,(),,5.5,,,,,,,,,,:,(),,,,,(),,,(),,,,,,,,,70%,,[11],,(),,,,[12],,,,,,,,,,,,,,,,,,,,,,47ChineseJournalofHealthPolicy,January2010,Vol3No1,,,,,,[1].[J].,2007(2):170178.[2],.[J].,2008,4(4):120121.[3].[M].:,2009.[4].[J].,2006(9):18.[5].[J].,2008,6(6):2324.[6].:[J].,2008(10):11.[7].[J].,2007(13):4950.[8].[J].,2007,9(5):112114.[9].[J].,2009,3(6):138139.[10].[J].,2008(7):1315.[11][R].,2007.[12],,.[J].,2009,2(8):3235.[:20091124:20091205](),,,,,1.,,,,,2.,,5,,,30,,,,3.:1),;2),,;3),;4),,,,,,()48