增强医疗保障减贫效应的再分配实现机制研究——基于改善亲贫性的视角

Research on the Redistribution Mechanism to Enhance the Poverty Reduction Effect of Medical Security:Based on the Perspective of Improving Pro-poorness

医疗保障制度既是打赢脱贫攻坚战的制度途径之一,也是2020年后减贫战略必然依赖的重要制度体系之一。通过发挥制度的"正向"收入再分配功能,改善亲贫性,推进公平减贫,是增强医疗保障制度减贫效应的实现路径。具体而言,基本医疗保险及大病保险要着力提高低收入群体的受益水平,促进福利改善的群体间均衡,医疗救助要有效发挥"纠正"社会医疗保险制度逆向再分配的补偿效应。为此,社会医疗保险要提高筹资累进性和推动保障待遇群体公平,医疗救助要推进筹资公平、优化支出结构、完善瞄准和衔接机制,以改善医疗保障制度的亲贫性,进而增强减贫效应。

Medical security system has not only been one of the institutional approaches to win the battle of poverty alleviation,but also one of the important institutional systems on which poverty reduction strategy will inevitably rely since 2020.This paper deems that the realization path of enhancing the poverty reduction effect of the medical security system is to carry out the "positive" income re-distribution function of the system,improve the pro-poorness and promote fair poverty reduction.Specifically speaking,the basic medical insurance and the serious disease insurance should focus on improving the beneficial level of the low-income groups and promoting the balance of welfare improvement among groups.What’s more,medical assistance should effectively play the compensative effect of "correcting" the reverse redistribution of social medical insurance system.Therefore,social medical insurance should improve the progressiveness of financing and promote the group equity of security treatment.Medical assistance should promote the equality of raising money and improve the expenditure structure,complete the targeting and linking mechanism,aiming to improve the pro-poor nature of the medical security system,and then enhancing the effect of poverty reduction.