城镇职工基本医疗保险制度:成效与困境突破

The Results,Dilemma and Measures in Basic Medical Insurance System for Urban Employees

城镇职工基本医疗保险制度运行有10多年,取得了怎样的成效,还面临怎样的困境以及如何改进,这些问题很是值得研究。本文分析了城镇职工基本医疗保险制度在统筹层次、账户设置以及支付方式设计上的缺陷,并提出了优化取向:即城镇职工基本医疗保险应该提高到地市级统筹、取消个人账户、采取混合支付方式并完善筹资机制。

After 10 years of implementation of the basic medical insurance system for urban workers, it was worth of studying the achievements, difficulties to be faced and improvement measures. In this paper the shortcomings about the basic medical insurance system for urban employees in the overall financing level, account setup and payment design were analyzed, and the optimization orientation then proposed, which were that the basic medical insurance system for urban employees should be enhanced the overall financing level from the county level to prefecture level, personal account should be canceled, compound payment should be adopted and the financing mechanism should be improved.