我们需要怎样的城乡居民医保财政补贴机制

What Do We Need for the Premium Subsidy Mechanism of China's Urban and Rural Residents' Health Insurance

在城乡一体化进程中,财政对城乡居民医保的财政补贴规模逐年递增。但现行补贴机制的弊端也逐步暴露出来,如财政补贴调整缺乏科学测算、政府补贴地区间失衡等。完善的城乡居民医保的财政补贴机制应当考虑资金筹集、资金分配、资金运营和管理的各个环节,包含对支出规模、支出结构、支出责任、支出管理与效果等多方面的考量。其中,关键是建立筹资增长的精算机制、补贴动态调整机制、政府间责任分摊机制和补贴资金的绩效评价机制。

During the process of urban-rural integration of the health insurance,the premium subsidy scale has being expanded year by year.At same time,the current subsidy mechanism obviously becomes more and more defective.Problems such as lack reasonable calculation of the adjustment of the subsidy level,the imbalance situation among diff erent areas are arising.For this situation,the paper demonstrates a premium subsidy mechanism which include different parts of fund-raising,fund-distribution,fund operation and management,considering the scale,structure,management and assessment of the premium subsidies.Among all the components,the key mechanisms are the actuarial mechanism of financing growth,the dynamic adjustment mechanism of premium subsidies,the mechanism of contributing liabilities among different government levels and the performance measurement system for the subsidies.