摘要
本文基于大病保险和城镇居民基本医疗保险融资一体化的视角,综合考量医疗费用增长水平、保障水平、保障范围等多重因素,对我国31个省、市、自治区的城镇居民医保体系的可持续性进行动态预测,评估大病保险推广对我国城镇居民医保制度的基金收支带来的平衡风险。测算发现,在不同的假设之下,到2015年,我国最少有9个省市、最多达到15个省市出现城镇居民医保基金累计结余赤字,城镇居民医保基金累计结余最低将出现13.63亿元的赤字。为保证城镇居民医保制度的可持续性,需优化城镇居民基本医疗保险和大病保险的保障水平,合理确定保障范围,有效控制医疗费用增长。
The paper proceeded from the perspective of financing integration of Urban Resident Basic Medical Insurance System and Supplementary Major Medical Insurance. It conducted a dynamic projection of the sustainability of the Urban Resident Basic Medical Insurance System of provinces, municipalities and autonomous regions, fully taking into account factors such as medical expenditure growth, the compensation level and the scope of coverage. The purpose is to find out whether the operation of Supplementary Major Medical Insurance will break the balance between income and expenditure of the Urban Resident Basic Medical Insurance System. The projections revealed that nine to fifteen provinces would face fund deficit under different assumptions, while the national fund deficit would reach 1. 363 billion RMB by 2015 as the worst scenario. The Paper suggested that we should optimize the compensation level and the coverage scope of Urban Resident Basic Medical Insurance System and Supplementary Major Medical Insurance, as well as control the growth of medical expenditure reasonably.
出处
《保险研究》
CSSCI
北大核心
2014年第1期98-107,共10页
Insurance Studies
基金
中国保监会部级研究课题重点项目"保险业参与大病保险制度研究"
教育部人文社会科学重点研究基地重大项目"我国社会发展与民生保障战略研究:以构建公平和可持续的医疗保障体系为例"(项目号13JJD840004)的资助
关键词
大病保险
医保基金
可持续性
Supplementary Major Medical Insurance
medical insurance fund
sustainability
