京、沪、穗居民医保与医疗救助政策比较研究

Comparison study of the implementations of BURMI and UMA in Beijing, Shanghai, and Guangzhou

市场化改革之后，中国计划经济时代的城镇公费医疗与劳保医疗制度走到了尽头，于1990年代由城镇职工基本医疗保险制度所取代。然而职工医保并不是一项囊括全体城镇人口的普遍社会保险，并未覆盖数量庞大的城镇失业与无业人群，而此类群体恰恰构成了中国城镇贫困人口的最主要部分。在相当长的时间内，中国城镇中最需要医疗救济的群体反而最缺乏政策保障，这种不合理的缺位直到2007年前后城镇居民基本医疗保险与城市医疗救助制度逐步成型后方才得到初步缓解。本文以北京、上海、广州三地的居民医保与医疗救助政策作比较研究，以此探讨中国新时期城镇医疗保障制度建设的内在逻辑。

After the market economic reform in China, the planned-economy based Government Insurance Program and Labor Insurance Program were no longer feasible, replaced by the Basic Urban Labor Medical Insurance Program （BULMI） in the 1990s. Yet BULMI is not a universal social insurance program covering the whole city population, it rules out numerous urban unemployment and jobless people, the major composition of China urban poor. In a considerable period of time, those need medical assistance the most received the least policy benefits. This gap was initially fixed at 2007, after enacting the Basic Urban Resident Medical Insurance Program （BURMI） and Urban Medical Assistance Program （UMA）. This article is based on a comparison study of the implementations of BURMI and UMA in Beijing, Shanghai, and Guangzhou, discussing the internal logic of the China healthcare policy development.