基本医疗保障制度受益情况分析及政策思考

如何提高各项基本医疗保障制度的受益水平,逐渐建立统一的中国特色的健康保障制度框架,是此次医改的重要任务之一。本文主要结合地区调研,分析目前基本医疗保障管理体制的现状,比较新农合、城镇职工和城镇居民医保参保人群的受益情况和基金运行效率,总结当前由制度分割所造成的行政成本上升、基金管理效率低下、费用控制难度加大等问题,提出将供方和保方结合的政策思考以及促进政策框架整合的相关政策建议。

A benefit analysis and policy consideration of basic health insurance system

One important objective of current health care reform is to expand the coverage,and to increase the participants＇ benefits of basic health insurance system（BHIS）,then to construct an uniform health insurance according to China＇s characteristics.With data from our survey,this paper mainly analyzes management problems of BHIS.We compare the benefits participants separately getting from New Rural Cooperative Medical Scheme,Urban Employee Basic Medical Insurance and Urban Residents＇ Basic Medical Insurance,and we conclude that the current segmented system has caused high administration cost,inefficient fund management and the difficulty of health care cost control.Based on this research,we provide a policy recommendation to promote integration of the health insurance and health service delivery system.