完善生育医疗保险待遇制度研究

Research on the Improvement of Maternity Medical Insurance System

我国生育医疗保险待遇采取总额控制、定额制和限额制支付标准,与女性生育实际医疗费用支出差距较大,导致女性自行承担大部分生育医疗费用,不利于女性生育健康权的实现,与生育保险制度价值理念不符,也难以促进我国"全面二孩"人口战略目标的实现。为了彰显生育社会价值,促进我国经济发展,在"生育保险和基本医疗保险合并实施"管理体制下,我国有必要实行全额支付女性生育医疗费用的保险待遇,从而保障母婴健康,实现社会公平。

The maternity medical insurance system in our country adopts the total amount of control, quota system and the maximum amount of payment system. The payment standard is relatively low and has a big gap with the actual medical expenses on reproduction. Women have to bear most of maternity medical expenses, and female workers maternity insurance right is difficult to be fully realized. China＇s ＂universal two-child policy＂ population strategy is also not easy to be implemented. In order to highlight the value of fertility and promote the economic development of our country, it is necessary to pay the full amount of reproductive health insurance so as to protect women＇ s maternity health and achieve social equity under the current management system of ＂maternity insurance merged with basic medical insurance＂.