A市医疗保险制度的研究.doc

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摘要:医疗保险是指政府通过立法,当被保人生病或受伤时,由政府给予物质,或社会的支持,从而提供了一个社会医疗服务或经济补偿系统的。现在主要是由我国的医疗保险,医疗保险,公共卫生和社会保险组成的三个保险制度。现在,中国是在社会主义初级阶段基本国情下,医疗保险改革的发展方向为始建职工医疗保险为主体的,保险和医疗救助为补充,覆盖所有城镇职工和员工医疗保障制度。

   在本文中,根据苏州市及部分省、市、区的医疗保险制度的改革,对于我们国家分析和评价了医疗保险制度的运作效率:改革已经取得了一定成效,尽管中国基本医疗保障制度的框架已基本形成,但依旧存在许多问题,不少数量的社会成员没有加入医疗保险,医疗卫生体制改革不到位,“看病难,看病贵”老大难问题,医疗保险基金风险抵抗能力弱,影响可持续发展的改革等。政府应该增加对医疗保障制度的投入,并确保公平分配医疗福利资源,努力缩小目前的不公平性的医疗保险制度,加快建设医疗保障法制建设,完善相关政策,充分发挥社会、市场、企业和农户的积极性和主动性,从各行各业云集各方资源,并最终建立一个“以人人享受基本医疗保障,建立安全系统,安全模式多样化,多层次的安全水平,多渠道融资,管理和服务社会化”的医疗保障系统。

关键词 医疗保险;苏州医保;社会保障制度分析

 

Abstract:Health insurance refers to the government through legislation, social members when they are sick or injured, give the material by the government, or the social support, thereby providing a social medical service or economic compensation system. It is mainly composed of China medical insurance, medical insurance, three insurance system of public health and social insurance. Now, China is in the fundamental realities of the primary stage of socialism, the development direction of the medical insurance reform, in our country road, was built to employee medical insurance as the main body, insurance and medical assistance for added, covering all urban workers and staff medical insurance system.

   In this paper, according to the reform of Suzhou and part of the province, city, area of the medical insurance system, the operation efficiency of our country analysis and evaluation of the medical insurance system reform has achieved certain results: due to frame China's basic medical insurance system has been basically formed, but there are also many problems, a lot of social members have not joining the medical insurance, medical and health system reform is not in place, "see a doctor difficult, expensive medical treatment" the seriousness of the problem, the medical insurance fund risk resistance ability is not strong, affecting the sustainable development of the reform. we suggested, the government should increase the investment on the medical security system, and ensure fair distribution of health care resources, efforts to reduce inequity of current medical insurance system, accelerate the construction of medical security system construction, improve relevant policies, give full play to the social, market, enterprise and initiative and farmers, from all walks of life gathered all resources, and ultimately to create a "to enjoy the basic medical security establish security system, security model, security level of diversification, multi-level, multi-channel financing, medical security system management and service socialization".

Keywords  medical insurance  Suzhou medical insurance  analysis of the social security system