社会医疗保险水平适度性研究——以上海市为例

Research on the Moderation of Social Health Insurance Level:Taking Shanghai as an Example

上海市社会医疗保险的覆盖面、统筹层次、补偿标准、人均预期寿命等方面居全国之先。通过运用相关定量模型对社会医疗保险水平及其"适度性"进行测度,发现当前其社会医疗保险水平低于适度水平的下限,证明医疗保险水平供给不足。要实现上海市社会医疗保险水平的总体适度平衡,可以从调整制度设计、明确基本医疗保险范围、优化医疗资源的配置等方面着手,实现上海市社会医疗保险制度运行与社会、经济发展良性互动,最终实现上海市社会经济的可持续发展。

Current social health insurance in Shanghai stands in the front of the whole county, especially in its coverage, pooling level, compensation standard, life expectancy and so on. This paper estimates the basic medical insurance and its premium rate by related quantitative models. The conclusion is that the level of medical insurance is under the specific height and its supply is still in shortage. There are several ways to reach the moderate degree, such as designing and adjusting the system, clearing the scope, optimizing allocation of resources. It helps lead a benign interaction between the system operation, society and economy and finally realize a sustainable development of economic society in Shanghai finally.