文章摘要

新中国成立 70 年来农村医疗保障制度变迁及其经验启示

The Evolution and Enlightenment of China's Rural Medical Insurance System in the Past 70 Years

DOI：

英文关键词: 70 years Rural medical insurance system Institutional change Enlightenment

基金项目:国家社会科学基金项目“新农村建设进程中西部农村医疗保障的长效运行机制研究"(06CSH017)。

作者	单位
孟宏斌	陕西师范大学

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中文摘要:

新中国成立 70 年来,政府主导建立的农村医疗保障制度在保障农民获得基本医疗卫生服务、缓解“因病致(返)贫”方面发挥了重要作用。从制度变迁的视角,农村医疗保障制度的变迁过程主要分为萌芽兴盛、衰退解体、恢复重构、新农合试点及城乡居民医疗保险五个阶段。为实现农村医疗保障制度的持续规范发展,必须在功能定位层面,始终坚持基本医疗服务的公共产品性质,确保农村居民公平享有健康医疗保障的权利;在体系建设层面,构建多元化、多层次农村医疗服务保障体系,减缓城乡居民医疗保险的制度压力;在运行主体层面,将“政府主导、农户主体”作为制度持续发展的基点,强化参保农民利益保障机制建设;在覆盖范围层面,关注以农民工为主体的流动群体的参保补偿方案,考虑建立贫困农民群体的长效参保机制;在发展趋向层面,按照基本医疗服务均等化的目标,逐步建立全民统一的医疗保障制度。

英文摘要:

Since the founding of the People’s Republic of China, the government established rural medical and health care system which has played an important role in ensuring farmers’ access to basic health services and preventing farmers from “poverty due to illness and returning to poverty due to illness”. From the perspective of institutional change, the process of rural medical security system can be divided into five stages: germination and prosperity, recession disintegration, recovery and reconstruction, pilot project of new rural cooperative medical system and medical insurance for urban and rural residents. In order to achieve the sustained and standardized development of rural medical security system, we must always adhere to the nature of public goods of basic medical services and ensure the framers access to the right of health and medical security equitably. We will build a diversified and multilevel rural medical service security system to ease the institutional pressure on medical insurance for urban and rural residents. We will take “the governments leading position and the farmer main body” as the basis for standardizing sustainable development, and strengthen the construction of the protection mechanism for the insured peasants' interests. We will pay attention to the insurance scheme of migrant workers as the main body of floating groups, and consider the establishment of a long-term insurance mechanism for poor farmers, and gradually realize a unified medical security system for the whole people in accordance with the overall goal of the integration of basic medical care.

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