全民医保论文：中国医保一体化研究

全民医保论文：中国医保一体化研究 全民医保论文:中国医保一体化研究 【中文摘要】健康权属于每个公民,全体社会成员不应因社会地位、经济收入、地域特征、性别和年龄等因素的不同而区别对待,每个社会成员都有权按照自身的经济承受能力来选择自己需要的医疗保障,这是医疗保险的机会均等问题。覆盖全民的医疗保险制度是中国新医改的目标。随着城乡一体化的发展和户籍制度的改革,学者开始从政治角度和经济角度讨论全民医保的必要性和可实现性。我国目前医疗保险市场存在着诸多问题,比如覆盖面不广、未能涵盖弱势群体、医疗保险筹资公平和服务利用不平衡等。其中,覆盖范围是最为突出的问题。本文基于机会均等理论和对全面医保概念的界定,从机会均等的角度我国医疗保险制度缺乏平等性的现状,用Probit模型分析了不同因素对我国医疗保险需求的影响并对实现全面医保的实现途径提出政策性建议。本文介绍了中国医疗保险制度形成的主要历程和发展趋势,通过历史分析法纵向考察了我国城乡医疗保险体制的变迁,并通过比较分析法描述了我国城乡医疗保障服务公平性差异的基本事实。本文从底线公平角度提出实现全民医保的必要性,并分析了目前其他国家实现全民医保的成功典范,诠释了全民医保的概念和目前我国实现全民医保的三种主要途径。底线公平有三个层次的,其中第一个层级,即是机会公平,这是实现全民医保的门槛和基本要求。文章实证部分以1989年到2009年至今CHNS所做的八次调查数据为依托,通过建立Probit模型,从个人特征,地区特征,electricity at no cost, revenue from electricity sales. Poverty alleviation to the removal, to desperate farmers out of poverty, in conjunction with urbanization, new communities are centrally placed. Poverty in the enterprise, enterprise more powerful, more social responsibility, they should allow more people to enjoy the fruits of development. Conditions to encourage private enterprises to establish Charity Fund for poverty alleviation, employment, grants, financial aid and other forms of poverty alleviation activities, let poverty alleviation aid corporate social responsibility in the specific embodiment, the proper meaning of giving back to the community. Finally reveals to implement poverty alleviation policies, older age, incapacity, cannot be achieved through industry support and employment support, such as poverty, children and unable to support the poor, Lo-Fi policy reveals the role to play, eventually incorporated into the low range, and fundamentally solve the problem of poverty. (C) establishing and perfecting retreat mechanism. Poverty alleviation is a dynamic project, we must strengthen the farmers ' information management, dynamic management of poor, really "poor" no place to hide, "poverty" a timely exit, "poor" and "return to the poor" get maximum support and help. To build up the information network system of the poor, poverty the basic information and dynamic entry to the system, to implement dynamic management. According to pro-poor development, timely adjustment on 职业特征和工资收入等方面分析了影响参保行为的主要因素和医疗保险在不同特征的群体中的分布情况。实证结果明,我国的医疗保险存在着明显的不公平性,参保行为主要受年龄、性别、职业特征和教育水平的影响,参保行为受城乡这一因素影响不大。这与过去的文献中认为城乡的医疗保险覆盖率存在着巨大差异的结论相悖,本文认为这在很大程度上得益于新农合的实施,而且本文所选调查数据只是关注覆盖率的状况,在城乡医保深度公平上的差异无法体现。教育年限是对医疗保险的参与情况影响最大的因素,教育因素从直接和间接方面制约着一个人对医疗保险的重视程度和购买能力,文章在政策建议部分提出加强国民教育,提高医保知识宣传等建议,通过高水平教育提高整体人口素质,并带动医疗保险市场的发展。最后,对我国医疗保险市场的改革方向提出展望,在现行城镇职工医疗保险制度、城镇居民基本医疗保险制度和新型农村合作医疗保险制度三网并行的基础上,逐步通过“三网并两网”,“两网合一”等步骤,逐步实现中国的医保一体化。本文创新之处在于:在考虑对影响医疗保险参与情况的影响因素时,选用人口、地域、职业、收入等人口学特征和经济特征,符合国外相关领域的研究视角,并且在前人的研究视角上,加入了职业特性这一影响因素,具有创新性;实证分析数据来自中国健康与营养调查(CHNS),样本量大,比国内研究学者实地调研、统计网站数据所得数据更加详细,外国研究学者在研究中国问题时,普遍采用这一数据库;本文选用数据更新到2009年,为最新数据,更能代表目前国内的基本情况,使实证研究更有说服力。 electricity at no cost, revenue from electricity sales. Poverty alleviation to the removal, to desperate farmers out of poverty, in conjunction with urbanization, new communities are centrally placed. Poverty in the enterprise, enterprise more powerful, more social responsibility, they should allow more people to enjoy the fruits of development. Conditions to encourage private enterprises to establish Charity Fund for poverty alleviation, employment, grants, financial aid and other forms of poverty alleviation activities, let poverty alleviation aid corporate social responsibility in the specific embodiment, the proper meaning of giving back to the community. Finally reveals to implement poverty alleviation policies, older age, incapacity, cannot be achieved through industry support and employment support, such as poverty, children and unable to support the poor, Lo-Fi policy reveals the role to play, eventually incorporated into the low range, and fundamentally solve the problem of poverty. (C) establishing and perfecting retreat mechanism. Poverty alleviation is a dynamic project, we must strengthen the farmers ' information management, dynamic management of poor, really "poor" no place to hide, "poverty" a timely exit, "poor" and "return to the poor" get maximum support and help. To build up the information network system of the poor, poverty the basic information and dynamic entry to the system, to implement dynamic management. According to pro-poor development, timely adjustment on 【英文摘要】The right of health belongs to every citizen; all social members should not be discriminated because of the different factors such as social status, income, geographical features, gender and age. Every member of society is entitled to choose their own medical insurance system according to their economic capacity, which is an equal opportunity issue. Covering all people by several medical insurance systems is the goal of new health reform in China. As the trends of urban-rural integration development and household registry reform, it begins to bring up the thought of the true unified basic health insurance and discuss the necessity from the viewpoint of social politics and economics. There are many problems in China’s current health insurance market, such as coverage is not broad, vulnerable groups are not covered by medical insurance and services and use of the health insurance is imbalance. However, the problem of coverage is the most prominent problem. Based on theory of the equality of opportunity and definition of the concept of comprehensive health care, from the perspective of equal opportunities, in my paper, I analyze the lack of equality in the health insurance system, using the Probit model to analyze the different factors on the impact of health insurance and provide some policy electricity at no cost, revenue from electricity sales. Poverty alleviation to the removal, to desperate farmers out of poverty, in conjunction with urbanization, new communities are centrally placed. Poverty in the enterprise, enterprise more powerful, more social responsibility, they should allow more people to enjoy the fruits of development. Conditions to encourage private enterprises to establish Charity Fund for poverty alleviation, employment, grants, financial aid and other forms of poverty alleviation activities, let poverty alleviation aid corporate social responsibility in the specific embodiment, the proper meaning of giving back to the community. Finally reveals to implement poverty alleviation policies, older age, incapacity, cannot be achieved through industry support and employment support, such as poverty, children and unable to support the poor, Lo-Fi policy reveals the role to play, eventually incorporated into the low range, and fundamentally solve the problem of poverty. (C) establishing and perfecting retreat mechanism. Poverty alleviation is a dynamic project, we must strengthen the farmers ' information management, dynamic management of poor, really "poor" no place to hide, "poverty" a timely exit, "poor" and "return to the poor" get maximum support and help. To build up the information network system of the poor, poverty the basic information and dynamic entry to the system, to implement dynamic management. According to pro-poor development, timely adjustment on recommendations about the path for realize a comprehensive health insuranceIn my paper, I describe the formation of China’ s medical insurance system and the development trend of the main course, through historical analysis of the changes of urban and rural medical insurance system by longitudinal comparison; describe the basic facts of urban and rural differences in the fairness of health care services using method of comparative analysis. This article puts forward the necessity of universal health care from the point of equality of baseline, and analyzes some examples of foreign countries who have already to achieve a successful universal health care, define the concept of universal health care and three main ways to achieve universal coverage currently. There are three levels of equality of baseline, the first level, named equal opportunity, which is the threshold of universal health care and basic requirements. Empirical part of the article using date from 1989 to 2009, which made eight CHNS survey data as the basis, through the establishment of Probit model, from many factors such as the personal characteristics, regional characteristics, occupational characteristics and income, analyze the main factors which may affect the behavior of insuring medical insurance, and the distribution of the group of the medical electricity at no cost, revenue from electricity sales. Poverty alleviation to the removal, to desperate farmers out of poverty, in conjunction with urbanization, new communities are centrally placed. Poverty in the enterprise, enterprise more powerful, more social responsibility, they should allow more people to enjoy the fruits of development. Conditions to encourage private enterprises to establish Charity Fund for poverty alleviation, employment, grants, financial aid and other forms of poverty alleviation activities, let poverty alleviation aid corporate social responsibility in the specific embodiment, the proper meaning of giving back to the community. Finally reveals to implement poverty alleviation policies, older age, incapacity, cannot be achieved through industry support and employment support, such as poverty, children and unable to support the poor, Lo-Fi policy reveals the role to play, eventually incorporated into the low range, and fundamentally solve the problem of poverty. (C) establishing and perfecting retreat mechanism. Poverty alleviation is a dynamic project, we must strengthen the farmers ' information management, dynamic management of poor, really "poor" no place to hide, "poverty" a timely exit, "poor" and "return to the poor" get maximum support and help. To build up the information network system of the poor, poverty the basic information and dynamic entry to the system, to implement dynamic management. According to pro-poor development, timely adjustment on insurance in different characteristics. The empirical results show that there is a clear unfairness in China’s health insurance system. Participating behavior is mainly affected by age, gender, occupational characteristics and educational levels; participating behavior is not affected by the factor of urban and rural areas. There is a tremendous paradox about the conclusion compared to the past literatures which consider that the health insurance coverage in rural and urban areas exists a huge difference. To the extreme extent, this is due to the implementation of NCMS and because the survey data is only concerned about the coverage of the medical insurance, the depth difference of the urban and rural health care can not reflect in a fair way. Years of education is the most influential factors about involvement of health insurance, educational factors restrict a person’s emphasis on health insurance and purchasing power from direct and indirect aspects, the article puts forwards some policy recommendations for strengthening national education and suggests that high levels of education by improving the overall quality of the population can promote the health insurance market. Finally, I put forward about the reform of the medical insurance market. Based on the three networks of the basic medical insurance system for urban electricity at no cost, revenue from electricity sales. Poverty alleviation to the removal, to desperate farmers out of poverty, in conjunction with urbanization, new communities are centrally placed. Poverty in the enterprise, enterprise more powerful, more social responsibility, they should allow more people to enjoy the fruits of development. Conditions to encourage private enterprises to establish Charity Fund for poverty alleviation, employment, grants, financial aid and other forms of poverty alleviation activities, let poverty alleviation aid corporate social responsibility in the specific embodiment, the proper meaning of giving back to the community. Finally reveals to implement poverty alleviation policies, older age, incapacity, cannot be achieved through industry support and employment support, such as poverty, children and unable to support the poor, Lo-Fi policy reveals the role to play, eventually incorporated into the low range, and fundamentally solve the problem of poverty. (C) establishing and perfecting retreat mechanism. Poverty alleviation is a dynamic project, we must strengthen the farmers ' information management, dynamic management of poor, really "poor" no place to hide, "poverty" a timely exit, "poor" and "return to the poor" get maximum support and help. To build up the information network system of the poor, poverty the basic information and dynamic entry to the system, to implement dynamic management. According to pro-poor development, timely adjustment on employees, basic medical insurance system for urban residents and the new rural cooperative medical insurance system, we can realize the universal health care system step by step through “three nets to two nets”, and then “two nets to one net”.This innovation of my article is that:In considering the factors which impact the participation of health insurance, the choice of population, geography, occupation, income and other demographic characteristics and economic characteristics, coincide with the research field of foreign perspective, and based on the previous studies, I add the professional characteristics as the influencing factors, this is innovative; meanwhile, empirical analysis of data comes from China Health and Nutrition Survey (CHNS), sample volume is huge, and compared to data got from the domestic researchers on field research, statistical data from websites, the data from CHNS are more detailed. And foreign researchers in the study of China are widespread using this database. The selected data are from 1989, through 8 survey, the latest data update to 2009; due to updates of data 2009 was too late that domestic researchers generally select the data from CHNS to 2006. This paper using the data updated to 2009, it can be more representative of the basic situation of the domestic, and the empirical study are electricity at no cost, revenue from electricity sales. Poverty alleviation to the removal, to desperate farmers out of poverty, in conjunction with urbanization, new communities are centrally placed. Poverty in the enterprise, enterprise more powerful, more social responsibility, they should allow more people to enjoy the fruits of development. Conditions to encourage private enterprises to establish Charity Fund for poverty alleviation, employment, grants, financial aid and other forms of poverty alleviation activities, let poverty alleviation aid corporate social responsibility in the specific embodiment, the proper meaning of giving back to the community. Finally reveals to implement poverty alleviation policies, older age, incapacity, cannot be achieved through industry support and employment support, such as poverty, children and unable to support the poor, Lo-Fi policy reveals the role to play, eventually incorporated into the low range, and fundamentally solve the problem of poverty. (C) establishing and perfecting retreat mechanism. Poverty alleviation is a dynamic project, we must strengthen the farmers ' information management, dynamic management of poor, really "poor" no place to hide, "poverty" a timely exit, "poor" and "return to the poor" get maximum support and help. To build up the information network system of the poor, poverty the basic information and dynamic entry to the system, to implement dynamic management. According to pro-poor development, timely adjustment on more convincing. 【关键词】全民医保 底线公平 机会公平 CHNS Probit模型 【英文关键词】Universal Coverage Equality of Baseline Equality of opportunity CHNS Probit Model 【目录】中国医保一体化研究 中文摘要 6-8 ABSTRACT 8-10 第一章 引言 11-17 1. 研究背景和选题的意义 11-12 2. 文献综述 12-15 3. 论文结构框架、创新点和不足 15-17 第二章 中国医保制度形成的主要历程和发展趋势 17-21 1. 初期的医疗保险体系 17-18 2. 改革探索时期的医疗保险体系 18-19 3. 医保制度的建设、完善时期和医保改革的发展趋势 19-21 第三章 中国城乡医疗保障服务公平性差异的基本事实 21-30 1. 我国卫生费用城乡分配的公平性 21-25 2. 我国医疗保险筹资的公平性 25-27 3. 我国医疗保险筹资使用状况比较 27-30 第四章 医保一体化的本质及实现途径 30-37 1. 全民医保下的底线公平 30-32 2. 目前世界全民医保的成功典范和中国的基本情况 32-34 3. 中国的全面医保概念的构建和三种实现途径 34-37 第五章 基于CHNS数据的机会公平性调查研究 37-48 1. 数据来源 37-38 2. 影响参保率的因素分析及数据特征描述 38-41 3. 模型设定 41-45 4. 回归结果分析 45-48 第六章 结论及政策性建议 48-52 1. 结electricity at no cost, revenue from electricity sales. Poverty alleviation to the removal, to desperate farmers out of poverty, in conjunction with urbanization, new communities are centrally placed. Poverty in the enterprise, enterprise more powerful, more social responsibility, they should allow more people to enjoy the fruits of development. Conditions to encourage private enterprises to establish Charity Fund for poverty alleviation, employment, grants, financial aid and other forms of poverty alleviation activities, let poverty alleviation aid corporate social responsibility in the specific embodiment, the proper meaning of giving back to the community. Finally reveals to implement poverty alleviation policies, older age, incapacity, cannot be achieved through industry support and employment support, such as poverty, children and unable to support the poor, Lo-Fi policy reveals the role to play, eventually incorporated into the low range, and fundamentally solve the problem of poverty. (C) establishing and perfecting retreat mechanism. Poverty alleviation is a dynamic project, we must strengthen the farmers ' information management, dynamic management of poor, really "poor" no place to hide, "poverty" a timely exit, "poor" and "return to the poor" get maximum support and help. To build up the information network system of the poor, poverty the basic information and dynamic entry to the system, to implement dynamic management. According to pro-poor development, timely adjustment on 论 48-49 2. 政策建议 49-52 参考文献 52-55 致 谢 55-56 学位论文评阅及答辩情况表 56 electricity at no cost, revenue from electricity sales. Poverty alleviation to the removal, to desperate farmers out of poverty, in conjunction with urbanization, new communities are centrally placed. Poverty in the enterprise, enterprise more powerful, more social responsibility, they should allow more people to enjoy the fruits of development. Conditions to encourage private enterprises to establish Charity Fund for poverty alleviation, employment, grants, financial aid and other forms of poverty alleviation activities, let poverty alleviation aid corporate social responsibility in the specific embodiment, the proper meaning of giving back to the community. Finally reveals to implement poverty alleviation policies, older age, incapacity, cannot be achieved through industry support and employment support, such as poverty, children and unable to support the poor, Lo-Fi policy reveals the role to play, eventually incorporated into the low range, and fundamentally solve the problem of poverty. (C) establishing and perfecting retreat mechanism. Poverty alleviation is a dynamic project, we must strengthen the farmers ' information management, dynamic management of poor, really "poor" no place to hide, "poverty" a timely exit, "poor" and "return to the poor" get maximum support and help. To build up the information network system of the poor, poverty the basic information and dynamic entry to the system, to implement dynamic management. According to pro-poor development, timely adjustment on