公共产品视角下我国新冠病毒疫苗筹资责任分担机制研究

Research on the Responsibility Sharing Mechanism of China's COVID-19 Vaccine Financing from the Perspective of Public Products

分析新冠病毒疫苗接种政策下医保负担及财政筹资责任共担需求,为卫生行政部门完善疫苗接种政策提供参考。对全国及各省疫苗接种费用进行测算,运用描述性分析探究医保负担及各省医保基金的运行风险及不平衡现状,运用公共产品理论探究财政投入需求及各级财政责任共担机制。职工医保个人账户占比高达约40%且仍未完全实现统筹管理,居民医保占比较小,且增长逐步趋缓。疫苗接种需求将直接消耗当年可统筹基金结余的38%以上。过度使用基金结存有可能带来不可持续风险,疫苗接种政策应由财政作为主要资金来源;从纵向和横向上财政存在不同程度不平衡。建议核算疫苗接种政策筹资需求;明确医保与财政筹资责任;建立财政筹资责任分担机制进一步完善疫苗接种政策的筹资机制。

This study analyzes the demand for medical insurance burdens and responsibility for fiscal responsibility under the COVID-19 vaccination policy,so as to provide references for the health administration departments to improve vaccination policy.This study calculates the vaccination costs of the whole country and all provinces,uses descriptive analysis to explore the medical insurance burden and the operation risk and imbalance of medical insurance funds in all provinces,and uses the public goods theory to explore the demand for financial investment and the sharing mechanism of financial responsibilities at all levels.The personal account of employee medical insurance accounts for about 40%,and the overall management has not yet been fully realized.The proportion of resident medical insurance is relatively small,and the growth is gradually slowing down.Vaccination will directly consume more than 38%of the fund balance in the current year.The excessive use of fund balance may bring unsustainable risks,and the vaccination policy should be financed by finance.There are varying degrees of fiscal imbalance both vertically and horizontally.It is suggested to calculate the financing demand of vaccination policy,clarify the responsibility of medical insurance and financial financing,establish a financial financing responsibility sharing mechanism and further improve the financing mechanism of vaccination policy.