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卫生经济研究[ISSN:1004-7778/CN:33-1056/F]

卷:

41

期数:

2024年01期

页码:

20-22，28

栏目:

医疗保障

出版日期:

2024-01-03

文章信息/Info

Title:

Challenges and Innovation Recommendations for Social Health Insurance Scheme Development in China

作者:

于保荣¹

1.对外经济贸易大学保险学院，北京 100029

Author(s):

YU Baorong

School of Insurance and Economics, University of International Business and Economics, Beijing 100029, China

关键词:

社会医疗保险制度; 医保筹资规划; 医保报销政策; 医疗服务价格; 中等收入陷阱

Keywords:

social health insurance scheme;  medical insurance financing plan;  medical insurance reimbursement policy;  medical service prices;  middle-income trap

分类号:

F840.684

文献标志码:

A

摘要:

中国社会医疗保险制度发展至今，已覆盖了95%以上的人口，筹资和报销待遇都达到了与国民经济所处的中等收入国家地位相称的水平，但也存在不同人群待遇相差悬殊、医保基金使用效率不高的问题。未来需要从实现公平的国民待遇、进行科学的医保筹资规划、制定统一的医疗服务价格、设计合理的医保报销政策、明确划分中央与地方政府的职责等方面，正视挑战，创新发展，避免医保制度发展的中等收入陷阱。

Abstract:

Since the development of social health insurance scheme(SHIS), it has covered over 95% of the population in China, and the current level of financing and reimbursement benefits has reached a level commensurate with that of middle-income countries. However, there are also problems such as wide difference in benefit among different groups, low efficiency of the utilization of SHIS funds. For its future development, it is necessary to focus on the realization of fair benefit for all, plan medical insurance financing scientifically, formulate unified medical service prices, design reasonable medical service insurance reimbursement policy, divide responsibilities between the central government and local governments clearly, to avoid the middle-income trap in SHIS development.

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更新日期/Last Update: 2024-01-03