日本健康保险制度演变历程及启示

对日本医疗保险制度实现全民覆盖的历程以及现状进行分析,发现日本的健康保险制度演变有以下特点：以法律为依据,逐步实现全民覆盖;建立了健康保险基金的合理分担机制;不同保健制度覆盖人群的服务包逐渐趋同、补偿水平逐渐统一;不同保险方案之间建立了风险分担和资金转移机制;加强对供方的约束力,控制医药费用快速上涨。最后针对日本健康保险制度的演变特点给出我国医疗保险制度改革的政策建议：健全医疗保险的法律法规;调整筹资机制,逐步提高个人筹资责任;推进不同医保制度覆盖人群保障待遇的统筹和统一;建立不同健康保险制度之间的风险分担机制;积极探索支付方式改革,控制医药费用快速上涨。

Evolution of health insurance system in Japan and its implications for China

This paper summarizes the evolution of health insurance system in Japan, analyzes its status quo, and finds some characteristics as below: based on the law, Japan achieved universal health coverage gradually; established reasonable financing mechanism between employers and employees; the insured from different pooling had the same benefit; established a sharing and financial transfer mechanism among different health insurance funds; increased control for providers to contain the rapid growth of medical expenditure. Finally, some implications were given to medical insurance reform in China: China should perfect health insurance related laws and regulations; adjust financing system and strengthen the responsibility of the insured; make great effort toward same benefit for people covered across different health insurance system; build risk sharing mechanism among different health insurance system; explore ways of payment reforming to contain the rapid growth of medical expenditure.