山东省居民基本医疗保险筹资现状与改进对策

Financing status and countermeasures of basic medical insurance program for residents in Shandong Province

目的比较山东省16地市居民基本医疗保险筹资政策的差异,探讨推进省级统筹的筹资政策建议。方法进行政策文本分析,比较不同地市在居民基本医疗保险的筹资模式、筹资标准、约束激励措施等方面的差异。结果山东省居民基本医疗保险筹资以固定等额筹资模式为主,政府财政补助转移支付为普惠性转移支付,现有的筹资机制对弱势群体的照顾不足,筹资的激励约束机制不健全。结论建议建立与区域经济发展水平相适应的筹资机制,建立财政补贴与缴费年限相关联的激励约束机制。

Objective To compare the differences in the financing policies of basic medical insurance program for residents in 16 cities in Shandong Province and explore the solutions for promoting provincial-level planning of financing policies.Methods By analyzing the policy texts,we compared the differences in financing models,financing standards,and constraints/incentives of basic medical insurance programs in different prefectures and cities.Results The financing for basic medical insurance programs for residents in Shandong Province is mainly based on the fixed equal amount financing mode.Since the government financial subsidy-based transfer payment is an inclusive transfer payment,the existing financing mechanism does not pay special attention to vulnerable groups and the incentive/constraint mechanisms of the financing is suboptimal.Conclusions It is recommended to establish a financing mechanism that is compatible with the level of regional economic development and to establish an incentive/constraint mechanism related to financial subsidies and payment years.