国外典型国家老年医疗保障制度比较以及对我国的启示

密级：学校代码：10075分类号：学号：20090307法学硕士学位论文学位申请人：赵琳指导教师：王金营教授学位类别：法学硕士学科专业：人口学授予单位：河北大学答辩日期：二○一二年五月ClassifiedIndex:CODE:10075U.D.C.:NO:20090307ADissertationfortheDegreeofM.LawForeignTypicalCountryElderlyMedicalSecuritySystemandItsEnlightenmenttoChinaCandidate:ZhaoLinSupervisor:Prof.WangJinyingAcademicDegreeAppliedfor:MasterofLawSpecialty:DemographyUniversity:HebeiUniversityDateoforalexamination:May,2012摘要I摘要老年人的医疗保障是大多数国家养老保障的重要组成部分，它为老年人退休后的医疗卫生服务提供了经济保障。在世界人口老龄化的趋势下，老年人口的比例不断上升，因此老年医疗保障的重要性就日益凸显，而老年医疗保障制度所受到的挑战也越来越严峻。中国的人口老龄化与发达国家相比具有速度更快，并且超前于经济发展的特点，这给我国还处于不断建设中的医保制度带来严峻挑战，因此，对该领域的研究就显得尤为迫切而重要了。由于各国的历史渊源、经济制度、政治制度和文化制度的不同，使得各国的老年医疗保障体系也不尽相同。林林总总，无论是发达国家，还是发展中国家，没有一个国家的医保体系是完美的，可以照搬的，但是我们可以从国外的一些做法中找出可借鉴之处。本文选取了英国、美国、日本、新加坡四个国家，它们分别是国家卫生服务保障模式、商业医疗保险模式、社会医疗保险模式和个人储蓄帐户医疗保障模式的典型代表。全面系统的介绍了这些国家的老年医疗保障体系和我国当前老年医疗保障现状的描述，通过对这些国外典型国家的老年医疗保障制度的比较研究，汲取各国老年医疗保障制度构建实施过程中的经验和教训，以便扬长避短，进一步探索适合我国社会发展的老年人医疗保障制度，从而为建立和完善多层次医疗保障体系，并昀终实现覆盖全民的医疗保障提供政策参考。关键词人口老龄化老年人医疗保障AbstractIIAbstractSeniorcitizens’medicalsecurityisanimportantpartofmostcountries’retirementwelfare,providingeconomicguaranteeformedicaltreatmentofretiredpeople.Intheageingtrendofworldpopulation,theproportionofagedpeopleisgettingsustaininggrowth,makingmoreobviousandflintyfortheimportanceofmedicalsecurityandthechallengeofagedmedicalsecuritysystem.Comparedwithdevelopedcountries,China’sagingtrendhassuchcharactersashigherspeedandsurpassing-economic-development,formingflintychallengeforChina’sconstructingmedicalsecuritysystem.Therefore,researchforthisfieldbecomesespeciallyexigentandsignificant.Duetodifferenthistoricorigin,economicsystem,politicalsystem,andculturalsystem,agedmedicalsecuritysystemforacertaincountryisdiverse.Neitherdevelopedcountriesnordevelopingcountriesareperfectandabletocopy,butusefulreferencecouldbefoundfromforeigncountries’measures.Britain,America,Japan,andSingaporeareselectedinthisarticle,respectivelyrepresentingpatternasnationalsanitationservicesecurity,commercialmedicalinsurance,socialmedicalinsurance,andindividualsavingaccountsecurity.ThisarticleroundlyandsystemicallyintroducestheconditionsofagedmedicalsecuritysystemfortheseforeigncountriesandChina,realizingexperiencelessonsfromthesetypicalforeigncountries’agedmedicalsecuritysystemthroughcomparingresearch.InthehopeofgettingfurtherresearchagedmedicalsecuritysystemwhichsuitsChina’ssocialdevelopment,thisarticlehopestoprovidepolicyreferencetoultimatelyrealizemedicalsecuritythatcoversallcitizensKeywordAgingofPopulationAgedMedicalsecurity目录III目录引言........................................................................................................................................1第1章导论........................................................................................................................21.1问题的提出................................................................................................................21.2研究目的....................................................................................................................21.3文献综述....................................................................................................................31.3.1国外文献综述..................................................................................................31.3.2国内文献综述..................................................................................................51.4典型国家的选择........................................................................................................81.5研究方法....................................................................................................................81.6研究内容....................................................................................................................81.7相关理论定义............................................................................................................91.7.1人口老龄化的判定标准..................................................................................91.7.2医疗保障..........................................................................................................91.7.3医疗保障制度..................................................................................................9第2章人口老龄化对医疗保障的影响..............................................................................112.1人口老龄化导致慢性病患病率日益上升..............................................................112.2人口老龄化直接影响医疗费用的增长..................................................................112.3人口老龄化影响医保基金来源..............................................................................11第3章我国人口老龄化及老年人的医疗保障..................................................................133.1我国人口老龄化现状及趋势..................................................................................133.2我国老年人的医疗保障现状..................................................................................133.3我国老年人医疗保障存在的问题..........................................................................153.3.1老年人医疗保障社会化程度低，覆盖面窄................................................153.3.2基本医疗保险保障水平偏低，与老年人医疗需求存在较大差距...