天津市卫生筹资的垂直公平和水平公平研究

目的:从垂直公平和水平公平角度分析评价天津市卫生筹资系统的公平性。方法:利用国家卫生服务调查和卫生总费用数据,运用AJL收入再分配方法分析天津市卫生筹资公平性。结果:天津市卫生筹资系统呈现亲穷人,改善了卫生筹资前收入分配的不公平,但不同卫生筹资渠道收入再分配作用不同。结论:强化直接税收的再分配职能;统筹社会医疗保险,改善筹资公平性;谨慎解释个人现金卫生支出筹资的"伪公平性"。

Analysis of vertical and horizontal equity of health financing for Tianjin Municipality

Objective: To analyze health financing equity from vertical and horizontal aspects for Tianjin municipality.Methods: With the data 2008 National Health Service Survey of Tianjin and its health account data,employing AJL method to measure the concerned data results.Results: The combined health care finance of Tianjin is pro-poor redistributive,which can narrow the primary income distributive gap,but different financing channel varies in income redistributive effect.Conclusion: Redistributive function of direct tax should be strengthened.Effort should be made to unify social health insurance system to enhance financing equity.Importance should be attached to the feint equity of OOP’s progressive and redistributive effect.