我国社会医疗保险“逆向转移”现象研究

Research on Reverse-income Redistribution in Social Health Insurance in China

社会医疗保险是保证社会成员公平享有基本医疗服务,促进全民健康水平提高的重要工具,但部分微观制度设计的不当,造成社会医疗保险在收入再分配上呈现从低收入者向高收入者转移的"逆向转移"情况,是一种效率和公平的双损失。文章从微观制度设计角度分析我国社会医疗保险出现收入再分配"逆向转移"现象的原因,提出通过在医疗保险费用征收和医疗保险待遇给付两个环节对相应微观制度设计进行调整,并结合其他国家经验,提出扭转这种收入再分配上的"逆向转移"现象的建议。

Social health insurance plays an important role in protecting the right of health in equal and promoting the health situation of people.Unfortunately,according to some improper design in social health insurance,the income redistribution in social health insurance turned to be a reverse-income redistribution situation.At this situation the income transfering from the low-income to the high-income makes the loss of efficiency and equality.From micro-system designing aspect,the paper analyzes the reason of ＂reverse transformation＂ in China＇s social medical insurance distribution,adjusts the micro-system design from medical insurance cost payment and medical insurance treatment,and proposes suggestions on ＂reverse transformation＂ of the payment distribution.