苏南现代化建设示范区经济、人口与社会医疗保险——以常熟市居民基本(农村合作)医疗保险为例

Economic Development,Population and Social Medical Insurance System in Modernization Construction Demonstration Areas of Southern Jiangsu——Taking Changshu Residents' Basic(Rural Cooperative) Medical Insurance as an Example

经济社会发展、人口老龄化和现代化社会医疗保险制度建设的关系,是当前苏南现代化社会医疗保险制度建设的重大课题。文章基于对常熟市居民基本(农村合作)医疗保险的研究,发现:政策延续与经济发展是以常熟市为代表的苏南现代化建设示范区社会医疗保险制度建设取得改革发展先机的重要因素;持续加深的人口老龄化程度对社会医疗保险基金安全和补偿支出结构的负面冲击已经逐步显现;提高补偿标准和改革支付方式在一定程度上优化了参保居民就诊结构,增强了社会医疗保险的宏观经济保障能力,但长期对提高社会医疗保险制度的宏观经济保障能力的作用非常有限。基于以上研究发现,提出政策建议:通过吸纳外来务工人员以优化参保人群年龄结构是解决人口老龄化挑战的关键;重视疾病预防,特别是慢性病早期预防,加强多部门疾病预防协同合作是应对人口老龄化的重要措施。

The relationship among economic and social development, population aging and construction of modern social medical insurance system is currently a major issue for the construction of modern social medical insurance system in south-ern Jiangsu. Based on the study of Changshu residents＆#39; basic （rural cooperative） medical insurance, the results show that：The continuity of policy and economic development play an important role in achieving reform and development opportuni-ties for the construction of social medical insurance system in modernization construction demonstration areas of southern Ji-angsu, such as Changshu; The degree of population aging continues to deepen and has an emerging nagative impact on the security and the structure of compensation payment of social medical insurance fund; To a certain extent, the measures, such as improvement of compensation standards and reform of payment, can optimize healthcare distribution structure for seeking medical services and promote the macro financing capability to enhance social medical insurance. However, they can only play a limited role in the long run. The paper suggests： The key is to optimize age structure of population by absorbing mi-grant workers; A great importance should be attached to disease prevention, especially early prevention of chronic diseases, and strengthening multisectoral cooperation in disease prevention is also an important measure to cope with population aging.