“扩面”与“整合”并行:统筹城乡医疗保障制度的路径选择

Extending coverage and integration:the paths to coordinate urban-rural medical security system

城乡医疗保障统筹发展必须秉持社会公正的原则。短期内不能期望通过扩大城镇职工医保制度来实现对城镇从业人员的全面覆盖,必须拓展新思路、新视野,考虑通过降低缴费型医保制度的门槛、建立普惠式非缴费型医疗保障制度以及完善基于家计调查的医疗救助制度来为未参保人群提供保障。在通过以职工医保、城居医保与新农合为框架的基本医疗保险制度实现全民覆盖的过程之中,必须要考虑不同制度之间的整合。当前制度全覆盖的重点在于职工医保,制度整合衔接的重点在于城居医保与新农合的并轨。

Principle of social justice should be upheld in the process of integrating the urban and rual medical security system. We can not realize the goal of universal coverage by extending current system and must explore new approaches for the uninsured including reducing the thresholds of the contributory medical insurance system, universal non-contributory medical security system and means-testing medical assistance system. Different systems should be coordinated during the process of full coverage by the basic medical insurance scheme, the urban-resident scheme and the rural cooperative medical system. Currently it is a priority that the coverage of the basic medical insurance scheme should be extended and the urban-resident scheme and the rural cooperative medical system should be coordinated.