城乡居民大病保险的若干争议与解决——基于公平与效率视角

Several Disputes and Solutions of Serious Illness Insurance——Based on the view of equity and efficiency

城乡居民大病保险从2012年实施以来,在解决居民因病致贫、因病返贫的问题上取得一定成果。大病保险的制度定位、筹资方面及保障方面有一些争议。从公平与效率的视角梳理思路,提出大病保险应定位为特惠型制度,大病保险适合单独筹资,大病认定应综合考虑病种、费用等多方面因素,合规医疗费用要突破基本目录,提倡大病保险不设置封顶线等建议。

Since the implementation of urban and rural residents illness insurance from 2012, some achievements have been made in solving the poverty of residents caused by illness issues. But there are some disputes over the specific operation process. The author sorts out ideas from the perspective of equity and efficiency, and recommends that serious illness should be positioned as a preferential system, suitable for separate funding; that in serious illness identification, illness type, cost and other factors should be considered; that compliance medical costs should break the base directory; and that catastrophic illness should not set the top line.