【作者】 李子芹；

【导师】 樊小钢；

【作者基本信息】 浙江财经学院 ， 社会保障， 2012， 硕士

【摘要】 城镇居民基本医疗保险的试点和推广填补了城镇老年居民、少年儿童、学生和其他城镇非从业居民在医疗保险制度上的空白,使城镇非就业居民有了与城镇职工和农村居民同等享受基本医疗保险的权利,保障居民身体健康,减轻了居民家庭的医疗负担,使参保居民不会陷入“因病致贫、因病返贫”的困境,切实保障了城镇非从业居民的医疗需求。它与城镇职工基本医疗保险制度、新型农村合作医疗制度共同构成了我国医疗保险制度的“三驾马车”,并将不断发展和完善,发挥着越来越重要的作用。本论文论述浙江省城镇居民基本医疗保险制度的发展历程,理清该制度在浙江省各地的实践情况,阐述参保范围、筹资标准和待遇水平等主要内容,并分析浙江省实施该制度的有利条件。在此基础上,试图对浙江省城镇居民基本医疗保险制度的运行情况进行绩效评析,通过运用政府责任、有效性、公平性和可持续性等指标体系对该制度进行全面、深入地分析,研究存在的问题,归纳总结取得的成效和经验,从而,对浙江省城镇居民基本医疗保险的发展和完善作深入思考。本论文主要分为五部分,第一部分为导论,阐明本论研究的研究背景、研究目的、研究的理论意义与实践意义,关于城镇居民基本医疗保险的文献综述,研究思路与研究方法,论文可能存在的创新和不足之处。第二部分,浙江省城镇居民基本医疗保险的实践情况,阐明制度的发展进程、实施条件,比较分析了浙江省各地试点方案的主要内容。第三部分,对浙江省城镇居民基本医疗保险制度进行系统的绩效评析,分别阐明政府责任、效率、公平和可持续性等评价指标,并运用这些评价指标,结合浙江省的实际情况进行分析和考核,从不同侧面分析取得的成效,研究出现的问题并剖析出现问题的原因。第四部分,完善浙江省城镇居民基本医疗保险制度的政策建议,基于第三部分的绩效评价和分析,提出几点政策建议:发挥政府职能,建立合理的财政补助机制,加快医保立法;完善筹集机制,保障稳定的基金来源;完善补偿机制,增强制度吸引力,保障参保居民的医保权益;加强基金管理,保证基金安全;实施配套改革,加强制度间的衔接,完善城镇居民基本医疗保障制度等。第五部分,结论与展望,通过前文的研究分析,得出结论,并展望今后需要进一步关注的问题。更多还原

【Abstract】 The pilot and promotion of the basic medial insurance for urban residents has filled the gaps in elderly residents, children, students and other the non-employed urban residents in medical insurance system blank, made the non-employed urban residents have the equally rights with urban workers and rural residents to enjoy the basic medical insurance, ensured them healthy, reduced their medial burden, insured them not be in“poverty caused by the illness, poverty due to illness”dilemma, effectively protected their medical demands. With the urban employee basic medical insurance system for and the new rural cooperative medical insurance system together,it constitutes our medical insurance system, "Troika", and will continue to develop and improve, playing an increasingly important role.This paper is mainly divided into five parts, The first part is introduction, to clarify the background theoretical significance and practical significance of the study, literature reviews on the basic medical insurance for urban residents, research ideas and research methods, paper innovations and shortcomings that may exist.The second part, the practice on the basic medical insurance for urban residents in Zhejiang Province. To clarify the development process, implementation of the systems, analyzing the main intents on the pilot program.The third part, the performance evaluation on the basic medical insurance system for urban residents in Zhejiang province ,to respectively set out the Government’s responsibility, efficiency, equity and sustainability of evaluation indexes , applied the evaluation indicators, combined with the practice of Zhejiang province, to analyze results and research on emerging issues.The fourth part, the policy recommendations on perfecting the basic medial insurance for urban residents in Zhejiang Province ,based on the third part of performance evaluation and analysis, made several points policy recommendations: play government functions, established reasonable of financial subsidies mechanism, speed up healthcare legislative; perfect raised mechanism, protect stability of Fund sources; perfect compensation mechanism, enhanced system attractive, protection parameter residents’healthcare interest; strengthening fund management, guarantee fund security; implementation supporting reform, strengthening system between of convergence, Improving basic medical insurance system for urban residents, and so on.The fifth part , the conclusions and the prospects, through the foregoing analysis, coming to a conclusion, and looking further attention to the problems in the future.更多还原