社会医疗保险统筹层次提升的分析框架的构建

Construction of Trade- off Theory of Enhancing Pooling Level of Social Health Insurance

通过深入分析当前社会医疗保险统筹层次涉及的异地就医、基金抗风险能力、道德风险三个重点方面,发现虽然统筹层次提升可以解决异地就医、基金抗风险能力的问题,但是也会造成道德风险的增加,且道德风险应当作为统筹层次设计的重点考虑。针对如何权衡统筹层次,首次提出医疗保险统筹层次提升的分析框架。只有权衡改革带来的利与弊,才能增进整个社会的福利和效用,也才能使医疗保险制度持续有效地运行下去。

This paper analyzed three aspects of the social health insurance , such as the access medical service in a place other than the resident region, risks of health insurance fund and moral hazard. Although the access medical service in a place other than the resident region and risks of health insurance fund can be solved, but there will be more moral hazard which should be treated as a important factor when the pooling level is designed. How to balance the pooling level between different regions , this paper proposed a trade - off theory of enhancing pooling level of health insurance. The welfare of the whole society and effectiveness will be promoted and the health insurance system would be continued to operate if the pros and cons of reforms were weighted.