开放视角下我国多元基本医疗保险体制的辩证分析

我国基本医疗保险改革经历了从单位保障到社会化保障、从单一制度到多元制度、从残缺窄覆盖到逐步覆盖全民的发展轨迹,形成了以城镇职工基本医疗保险、城镇居民基本医疗保险和新型农村合作医疗为主体的多元基本医疗保险体制。本文基于开放的视角,对多元基本医疗保险体制进行了辩证分析,通过对现有改革思路和地区探索的梳理,提出要适应城乡统筹、劳动力流动、自身可持续性的要求,多元基本医疗保险体制在2011年实现全覆盖之后的改革方向需从封闭走向开放。提出多元基本医疗保险体制改革的路径分为三步,并重点分析了全覆盖后(2012—2020年)多元基本医疗保险体制改革的对策。

School of Labor and Human Resources, Renmin University of China

The basic medical insurance reform in China has transferred from enterprise-based protection to the social protection, from a single system to a multiple system, from the incomplete blocket coverage to the progressive realization of universal coverage. It has formed a multiple basic medical insurance system, including the basic medi- cal insurance for urban employees, resident based medical insurance for urban residents and the new rural cooperative medical system as the main schemes. Based on an open perspective, the article dialectically analyzed the system, through the existing reform ideas and areas exploration first achieved, in a completed coverage in 2011, then voverage through establishing an open system to adapt and self-sustainability. The path of reform is proposed after the completed coverage （2012--2020）. , proposes multiple basic medical insurance system should be makes efforts to break the separated schemes into the universal the requirement of urban and rural integration, labor mobility by the three-step, and focused on analysis of reform measures