建设更加公平可持续的医疗保障制度

Establish a More Fair and Sustainable Medical Security System

本文在回顾我国医疗保障制度演进历史的基础上,从公平性、可持续性和制度运行效率三个视角审视现行制度,提出存在的三大问题:群体间待遇差距过大、基本医疗保险基金潜伏危机、制度"碎片化"运行绩效不高,并分析了原因。基于发展阶段的判断,提出了建设更加公平可持续的医疗保障制度的思路,并就加强制度整合衔接协调、优化制度设计、改进运行机制等提出了具体的建议。

Based on reviewing the evolution history of medical security system in China, we look at the current system from three perspectives such as fairness, sustainability and operation efficiency. In this paper, we think thereare three main problems in the medical security system： firstly the gap of security treatment between different groups is too large; secondly a serious crisis exists in the fund of basic medical insurance; thirdly the operation performance of the medical security system is not too high because of ＇fragmentation＇. Based on the judgment of the deyelopment stage of medical security system in China, we put forward a proposal to establish a more fair and sustainable medical security system, and give some specific advice on reinforcing the system integration, optimizing the system design, improving the operation mechanism and so on.