中国农村医保政策的非均衡供给及其后果——基于三个县市的实证分析

Unbalanced Supply of Chinese Rural Health Insurance Policy and the Consequences——Empirical Analysis Based on Three Counties and Cities

农村医疗保障作为参与精准扶贫的一种重要方式,是解决"因病致贫""因病返贫"问题的重要环节。然而,在当前中国精准扶贫政策下,农村医疗保障作为一项最基本的社会保障政策,其保障水平却在贫困户和非贫困户之间存在显著差异,从而导致群众满意度降低,影响了精准扶贫政策的有序推进,继而衍生了新的基层治理性问题。国家社会经济发展的不平衡以及地方政府的运动式治理的惯性思维是农村医保政策的非均衡供给产生的直接诱因。基于此,打破政策供给的非均衡局面,需要进行制度创新,创造条件实现基本公共服务的均等化,并做到"全民参保、应保尽保"。

As an Important Way to Participate in Precision Poverty Alleviation, Rural Medical Security is an important link in solving the problem of 'poverty caused by illness' and 'returning to poverty due to illness'. However, Under the current Precision Poverty Alleviation policy in China, rural medical security has a significant difference between poor and non-poor households, which as a basic social security policy has led to a lower satisfaction of the masses and affected the orderly progress of the precision poverty alleviation policy. The imbalance of social economic development and the inertial thinking of motive governance of local government is the direct cause of the unbalanced supply of rural health insurance policy. Based on this, the state needs to carry out institutional innovation, create conditions for the equalization of basic public services and ensure 'all people should be insured and guaranteed' in order to break the unbalanced situation of policy supply.