基本医疗保险关系转移接续的现状、问题与出路——基于典型地区试点运行的实证调查

The Current Situation,Problem and Solution to the Transfer and Continuing for the Basic Medical Insurance Relationship:An Empirical Investigation Based on the Pilot Operation in the Typical Regions

随着人口流动的增多,基本医疗保险关系转移接续成为重要的民生问题。本课题组采取文献法、跟踪访谈法比较分析各地医保关系转接政策异同,访谈深圳、上海、杭州等地转接政策制定人员、经办人员与转接参保人,了解了2010年7月至2012年7月医保转接的实践进展和待解难点,最终归纳出医保转接的五大核心环节,如缴费年限互认及折算、实际最低缴费年限设置、个人账户处理方式、待遇空挡、关系绑定;并在此基础上提出方案设计以及相关政策建议。

With the increase of population mobility, the transfer and continuing for the basic medical insurance relationship has become an important civil topic. Adopting the methods of literature study and tracking interview, the study compares the similarities and differences in the transfer and continuing polices of the medical insurance relationship in the different areas. The interviews are made among the policy makers, the managers and the in- sured people in Shenzhen, Shanghai, Hangzhou and other cities, so as to understand the practice progress and the existing difficulties in the transfer and continuing of the medical insurance from July 2010 to July 2012. Fi- nally, the five core steps are concluded, such as the mutual recognition and conversion of payment period, the requirement of the actual lowest payment period, the dealing mode of personal account, the neutral of treatment and the relationship binding, on the basis of which the suggestions for the program design and relevant policies are put forward.