中国城乡居民基本医疗保险制度发展历程、挑战与应对策略

Development,challenges and strategies of basic medical insurance system for urban and rural residents in China

中国城乡居民基本医疗保险制度是中国特色医疗保障制度的重要组成部分,其主要成效与基本经验得到了国际社会的广泛认同。本文梳理了其从单独建制逐步走向制度融合的发展历程,总结了制度发展的基本经验与主要成效,包括政府主导的组织管理和筹资机制,实现对非正规部门就业人群的全覆盖,初步构建了多层次医保体系、多种监管机制并存、创新社会事业管理等。同时分析了制度发展所面临的问题和挑战,并提出了相应的应对策略,即立足于我国经济社会发展现状进行制度融合和统筹层次的提高,并逐步建立公平稳定长效的筹资增长机制以及保障水平与平衡基金收支并举的补偿制度。

China′s basic medical insurance system(BMIS)for urban and rural residents is an important part of medical security system with Chinese characteristics.Main achievements and basic experience of the BMIS have been widely recognized by the international community.The study describes the development process of the BMIS changing gradually from an independent system to an integration system.The study summarizes experiences and effects of the system as following:organization,management and financing dominated by the government;full coverage to general populations including those with flexible employment;construction of a multi-level medical insurance system;multi-dimensional regulatory mechanism;and the innovation of social service management.Main challenges and countermeasures of improvement for the BMIS are also discussed.