东莞市全民医保的亮点、启示和建议

分析了东莞市＂用一个制度覆盖所有人群＂的全民医保模式,凸显了实施参保的＂三破除＂原则、城乡＂五统一＂的经办模式、创新政府投入机制以及实现城乡居民保障水平的公平性等亮点。该市逐步缩小城乡筹资与待遇水平的差别,适度调低费率,基本医保方案既体现一致性与统一性,又承认制度形式的差异和险种多样化等,对于加快迈向全民医保的步伐有一定启示。提出了实现全民医保还需完善制度,规范管理,强化对医疗服务供方的管理,提升自身的能力建设等建议。

The originality and implication of universal coverage in Dongguan

This paper analyzed Dong guan＇s universal coverage model of ＂one system covering all the people＂,which highlighted the principle of ＂three broken＂,agency model of urban and rural ＂five-unification＂,innovation mechanism of government investment and realizing equality of medical security level among urban and rural residents.We can get some enlightenment from their developmental experience to set up the national medical insurance system.Dongguan has been gradually narrowing the gap in financing and treatment level between urban and rural areas,moderately lowered expense rates.Its basic medical scheme not only reflects consistency and unitarily,but also admits differences among systems and diversification among different insurance schemes.It brings inspiration for speeding up towards universal coverage.In addition,the paper also believes that some of the major problems,such as,strengthening management of the supplier and enhancing its ability building and so on,must be paid enough attention in the further development.