我国灵活就业群体基本医疗保险缴费负担评估

灵活就业群体的合理参保是提升我国基本医疗保险制度参保质量的关键。本文基于中国家庭收入调查数据，对灵活就业群体医疗保险缴费负担进行评估。研究发现，具有较强医疗保障需求的低收入组灵活就业人员缴费负担最重，且存在缴费负担的困难群体占比最高；随着收入水平的提高，灵活就业人员的缴费负担逐渐减轻。随着消费层次从基本生活需求向正常生活需求的提高，灵活就业人员的缴费负担系数明显降低，缴费负担加重，尤其是对于低收入和部分中等偏下收入组群体。本文建议对于不同收入灵活就业群体，应给予不同的政策安排；在参保缴费政策的具体设计上，应更多体现参照个人实际收入水平的公平负担原则，并且政策应随时代特征、地区特点进行动态调整。

Assessment of the financial burden of basic medical insurance in flexible employment groups in China

Reasonable participation of flexible employment groups in medical insurance is key to improving the coverage quality of the Basic Medical Insurance System in China. By analyzing Chinese Household Income Survey results, this paper assesses the financial burden of basic medical insurance in flexible employment groups . The result shows that low-income flexible employment group who has the highest demand for medical insurance has the heaviest burden and also the highest proportion of individuals with a difficulty in affording the insurance; as the income level increases, the burden is gradually reduced. With the improvement of the consumption level from basic living needs to normal living needs, the coefficient of the financial burden is significantly reduced, and the financial burden becomes heavier, especially for all individuals from the low-income group and some individuals from the lower-middle-income group. The paper suggests that differentiated policy arrangements be made for different flexible employment groups with distinctive income levels. In the specific design of the medical insurance payment policy, the principle of fairness of burden with reference to each individual''s actual income level should be emphasized, and the policy should be dynamically adjusted along with the characteristics of the times and regions.