城镇职工基本医疗保险个人账户解读评析与建议——以安徽省铜陵市为例

The Interpretation Comments and Suggestions of Urban Employee Basic Medical Insurance's Personal Accounts——Taking Tongling City of Anhui Province as an example

城镇职工基本医疗保险个人账户的设置有特定的背景,其资金来源于两个主体,一是用人单位,二是参保职工。国家对"个人账户"支付范围的政策边界,造成了"个人账户"资金使用效率低下、保险功能弱化、管理监督成本高昂等问题。文章从参保者个人、管理部门、医疗保险制度三个视角出发提出了渐进式取消个人账户,提高住院待遇的政策建议。

Setting up personal accounts of the basic medical insurance for urban workers has a specific background, it＇s funds coming from two main bodies, one is the insured workers, the other is the employers. The national policy boundary of the payment range about the individual account has caused such problems as the low efficiency, the weakening of the insurance function and the high cost of management and supervision. The author puts forward the policy suggestions on the gradual abolition of individual account and increasing hospitalization treatment through the three perspectives,such as the insured individual, the management department and the medical insurance system.