基本医疗保险的边界划分

Drawing the Distinct Line of the Basic Medical Insurance

清晰的基本医疗保险边界是构建多层次医疗保险制度的前提,也是发展商业健康保险,形成医疗保险领域政府和市场分工协作的前提。本文讨论了边界划分的意义、基本原则和主要内容、基本方法、技术标准、认定程序和机构建设等,提出政府在基本医疗保险边界划分中需完成三个转变,即从"全能政府"转变为"有限政府"、从"实体规制"迈向"程序控制"、从"命令-服从"发展为"协商-合作"。

To drawing a distinct line of the basic medical insurance is the fundament of structuring a multilevel medical insurance system. This paper provides three angles of view to explain the meaning of the border of the basic medical insurance, and also suggests the main principles and the essential content to clarify the border. Comparing with the developed countries, the State should establish the technical standard, determinate process and the institutes. Meanwhile, the state should convert from all-powerful government to limited government, from substantive regulation to procedure regulation and from coercion the private parties to negotiation with them.