中国社会医疗保险财务收支中的障碍与突破

The Obstacles and Breakthrough in the Financial Revenue and Expenditure of Social Medical Insurance of China

财务收支是社会医疗保险制度运行的物质基础。近年来,财务收支失衡问题已经开始显现于我国社会医疗保险的部分统筹地区。其原因主要有责任主体、人口结构、财务机制、医疗递送等因素。为此,应该在走向全民医疗保险制度、加强医患双方的道德风险规避、扩展个人医疗账户的使用范围、适时建立退休人员的缴费制度等方面进行改革与发展。

The revenue and expenditure in financial system is the material base in the operation of social medical insurance system. The financial problem of the imbalance of the revenue and expenditure has appeared partially in the social medical insurance system of our country these years. The reasons lie mainly in the population structure, the financial mechanism, the medical transmission, etc. Therefore, we should reform the social medical insurance system in these aspects that are to move towards a national insurance system, to enhance avoiding the moral risk between hospitals and patients, to expand the scope of application of individual medical accounts, to timely establish the system for payment of the retired personnel.