我国农村地区实施大病统筹合作医疗或医疗保险方案的技术缺陷

An Analysis on Technique Defects of Catastrophic Medical Insurance in Ru- ral China

在我国中等发达及以上农村地区,大病统筹合作医疗或医疗保险以其可缓解农村居民的就医经济风险而受到欢迎,但是在方案的拟订过程中尚存在一些明显的技术缺陷,比如,“大病”的技术定义、农村居民就医经济风险分析、风险临界线界定、保险给付比测算和保险费率厘定等,这些技术的缺乏,已严重影响农村合作医疗或医疗保险的推广和实施效果。

The Catastrophic Medical Insurance (CMI) scheme is approved for its alleviating the financial risk of medical care services in rural China. However,there are still some technique defects in making a practicable proposal,such as measure of financial risk, poverty .critical standards of financial risk,definition of catastrophic threshold, the Contribution rate-making,and the restrictive conditions,et al. This paper presents an analysis on these technique defects.