我国基本医疗保险关系转移接续问题研究

The Transformation and Continuity of China's Basic Medical Insurance Relationship

随着全民医保制度建立以及人口频繁流动,医疗保险关系转移接续问题日益凸显。医疗保险关系转移接续的核心是转移接续人员获得医疗保险待遇的资格条件及转入地和转出地医疗保险经办机构之间的利益协调。职工医疗保险设置最低缴费年限导致的资格条件限制与地区之间缺乏有效的利益协调机制是目前我国转移接续难的制度性成因。要去除资格条件限制,就需要取消职工医疗保险最低缴费年限规定,退休职工按本人养老金的2%向其常住地职工医疗保险机构缴纳医疗保险费,并享受当地职工医疗保险待遇。要消除利益协调障碍,中央政府应采取按人头补贴方式,补贴净转入退休参保职工地区的职工医疗保险基金。测算显示,2014年,中央政府最高补贴金额不超过250亿元。通过以上制度设计,全体国民可以在全国无障碍流动,无障碍享受医疗保险待遇。

As the implementation of universal health care system and the frequent population flow, the portability of China^s basic- medical insurance is more and more important. The cores of portability are that how the insured acquire the medical insurance benefit and how the medical insurance funds coordinate interest conflict. The limitation of the minimum period of payment of the basic medical insurance for workers and the lack of effective interest coordination are the institution obstructions. We should abolish the minimum pe-riod of payment of the basic medical insurance for workers. The retirees could pay 2% of their own pension to the medical insurance fund where they live and acquire the benefit provided by the local medical insurance. The central government should subsidize medical insurance for the local government who accepted net retired insured workers. The subsidy could be fixed capitation. This paper estimates that the central government＇s subsidy would not exceed 25 billion in 2014. If the suggestions are adopted, all citizens could migrate and acquire the medical insurance benefit throughout the country without boundaries.