我国实现人人享有基本医疗保险的制度缺陷分析与制度调整思路

Defect Analysis and System Adjustment to Realize the Right of the Basic Medical Insurance System in China

"实现人人享有基本医疗保险"已然是保障城乡居民健康的重要策略。我国基本医疗保险体系为公共健康做出了积极贡献,然而,因制度设计缺陷,制度在运行中存在的问题日趋明显:"自愿参加"的逆向选择、部分人群重复参保、各类医疗保险制度衔接困难以及流动儿童缺少基本医疗保险制度安排等问题,已经在一定程度上影响基本医疗保险体系的正常发展,既不能实现"广覆盖"人人享有基本医疗保险的机会平等,也不能满足人们日益增长的医疗保险需求的结果平等。调整公共政策,以卫生平等满足基本医疗保险均等化,以卫生公平满足个别差异性的健康保障,已然是需要重视的问题。

＂Achieving universal access to basic medical insurance＂ is important strategy for guarateeing urban and rural residents health. The basic medical insurance system in China has made positive contributions on public health, however, because of the defect of system design, problems in the operation of the existing system is becoming more and more obvious： ＂ voluntary＂ adverse selection, part of the crowd repeated insurance, all kinds of medical insurance system is difficult to convergence, and the floating children lack the basic medical insurance system. It has affected the normal development of the basic medical insurance system in a certain extent. It neither realize ＂wide coverage＂ universal access to equality of opportunity in basic medical insurance, nor satisfy people＇s increasing demand for health insurance to the equality of result. The problems need to be paid attention as adjustment of public policy, health equal to meet the equal access to basic medical insurance and the health fair to safeguard the health of individual difference.