社会保障顶层设计亟待明确的三大问题

Three Major Urgent Problems at the Top Level Design of Social Security

社会保障制度体系建设的顶层设计亟待明确以下三个问题:一是现行城乡居民基本养老保障制度模式选择,建议将现行城乡居民基本养老保险制度中的基础养老金改为养老津贴,个人账户制度改为个人缴费制度,并相应地修改制度名称使定位更加准确;二是基本医疗保险和大病医疗保险以及各种医疗救助制度的定位和责任,建议从政策上明确基本医疗保险"保基本"的定位,整合制度体系,加强统筹基金支出管理,明确社会医疗救助的作用就是确保困难群体享有基本医疗保险的权利,使各级政府切实承担起"保基本"的责任;三是脱贫攻坚中"扶"和"救"的关系,建议整合扶贫和社会救助制度,高度重视城市的贫困问题,统筹考虑城乡贫困政策,统一国家的扶贫标准和低保标准,并与国际标准相衔接。

At the top level design of social security system construction,the following three problems need to be clarified： the first problem is the mode selection of the current basic old-age security system for urban and rural residents. It is suggested that the basic pension in the current basic old-age insurance system for urban and rural residents should be changed into pension subsidy,individual account system should be changed into individual payment system and accordingly modify the system＇s name to make a more accurate positioning. The second problem is the positioning and responsibility of basic medical insurance and serious illness medical insurance,as well as various medical assistance systems. it is suggested that we should make it clear the positioning of basic medical insurance is ＂ guaranteeing the basic medical insurance＂ on policy,integrate the system,strengthen the expenditure management for pooling fund,make it clear the role of the social medical assistance is to ensure that the disadvantaged groups have the right to acquire basic medical insurance and the governments at all levels conscientiously should be the responsible for the ＂ guaranteeing the basic medical insurance＂. The third problem is the relationship between ＂ help＂ and ＂ save＂ in the battle against poverty. It is suggested that we should integrate the poverty alleviation system and the social assistance system,attach great importance to the urban poverty problem,give overall consideration to urban and rural poverty policy,set up unified standard in poverty alleviation and subsistence security system which should link up with the international standard.