河北大学学报(哲学社会科学版) ›› 2019, Vol. 44 ›› Issue (2): 128-138.DOI: 10.3969/j.issn.1005-6378.2019.02.019

• 社会学研究 • 上一篇    下一篇

从“全民医保”到“公平医保”:中国城乡居民医保制度整合的现状评估与路径分析

仇雨临,张鹏飞   

  1. 中国人民大学 劳动人事学院, 北京 100872
  • 收稿日期:2018-10-15 出版日期:2019-03-25 发布日期:2019-03-25
  • 作者简介:仇雨临(1960—),女,北京人,中国人民大学劳动人事学院教授、博士生导师,主要研究方向:医疗保险。
  • 基金资助:
    国家社会科学基金项目“城乡统筹背景下我国医疗保障制度转型与路径选择”(13BGL114)

From “National Medical Insurance” to “Fair Medical Insurance”: Current Situation Assessment and Path Analysis of the Integration of Medical Insurance System for Urban and Rural Residents in China

QIU Yu-lin, ZHANG Peng-fei   

  1. School of Labor and Human Resources, Renmin University of China, Beijing 100872, China
  • Received:2018-10-15 Online:2019-03-25 Published:2019-03-25

摘要: 中国已经实现了“全民医保”,但医疗保障的城乡差距及不公平状况使制度保障效应大打折扣。推进城乡医保制度整合是实现医保公平的有效途径,是权利公平、机会公平和规则公平的集中体现。在实践中,城乡医保整合提高了参保人和医疗资源分配的公平性,包括扩大了覆盖面,实现了统一性,提升了保障度,促进了医疗资源的均等化配置等。但与此同时,分档缴费并与待遇挂钩的制度设计使得城乡居民医保制度整合过程中还存在公平性不足的问题。因此,需要进一步从推进实质公平、均衡医疗资源配置、提高统筹层次等角度,实现从人人参保到人人公平参保,最终实现“公平医保”。

关键词: 全民医保, 城乡居民医保整合, 公平性

Abstract: Despite the achievements of “national health insurance” in China, the urban-rural gap and unfairness of health insurance reduced the institutional guarantee effect. Promoting the integration of urban and rural residents basic medical insurance system is an effective way to achieve fairness in medical insurance, and it is the concentrated reflection of fairness in rights, opportunities and rules. In practice, the integration of urban and rural residents basic medical insurance system has improved the fairness of the insured and medical resources, including expanding coverage, achieving unity, improving security ability, and promoting the equalization of medical resources. At the same time, however, since the payment and treatment of the sub-files does not reflect the true fairness, there are still some problems of insufficient fairness in the integration process of the urban and rural residents basic medical insurance system. Therefore, it is necessary to further promote the “fair health insurance” from the perspective of promoting substantive equity, balancing the allocation of medical resources, and improving the standard of overall planning.

Key words: national health insurance, integrating urban and rural residents basic medical insurance system, fairness

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