医疗保障宏观筹资负担:国际视角与中国经验

The Macro Financing Burden of Health Insurance:An International Perspective and China's Experience

医疗保障宏观筹资负担能够反映医保制度对社会经济发展和家庭经济承受能力的适度性,是衡量医保制度运行效率的重要指标。本文厘清不同模式下典型国家的医疗费用统计口径,按照我国医保支出口径统计典型国家医保支出规模,结合宏观视角与微观视角、共时角度和历时角度,构建指标体系对各国的医保制度对经济发展适度性程度和医保制度运行效率进行比较,同时拓展研究内容至36个OECD成员国,并对同等经济发展水平和人口老龄化程度下的医保制度运行效率进行分析。研究表明,在3种典型医疗保险模式的8个国家中,我国医保制度对宏观经济社会和微观家庭的经济负担最轻,制度运行效率最高,但宏观成本增速最快。因此,建议抓住医保改革机遇期,着力降低医保支出增速,确保群众医保待遇改善和经济社会发展同向而动。

The macro financing burden of health insurance reflects the health insurance system's adaptability to socioeconomic development and the affordability of families.It serves as a crucial indicator for evaluating the operational efficiency of health insurance systems.This paper provides a clear statistical methodology for calculating medical expenses in typical countries and estimates the scale of health insurance expenditure in those countries using China's health insurance expenditure as a calibration reference.By adopting macro,micro,synchronic,and diachronic perspectives,this study establishes an index system to compare the adaptability and operational efficiency of health insurance systems across different countries.The research covers 36 OECD countries,focusing on countries with similar levels of economic development and population aging to analyze the operational efficiency of their health insurance systems.The findings reveal that among the nine countries and regions with three typical health insurance models,China's health insurance system imposes the lightest macroeconomic and microeconomic burden on society and families while exhibiting the highest operational efficiency.However,the growth rate of macro cost is the fastest.Therefore,this study recommends seizing the opportunity for health insurance reform,with a specific emphasis on reducing the growth rate of health insurance expenditure and ensuring that benefits improvements align with economic and social development.