生育保险欺诈行为分析及对策

Analysis of maternity insurance fraud and suggestions for countermeasures

当前我国生育保险欺诈骗保案件频发,欺诈行为呈现主体多元化、手段多样化的特点。结合舞弊三角理论分析欺诈行为成因,发现各主体面临的压力是导致欺诈行为的客观外因,信息不对称、制度不健全、监管效能低下为欺诈行为的实施提供了可乘之机,贪婪心理、从众心理、侥幸心理等自我合理化心态是欺诈行为实施的主观内因。因此,从减轻各主体压力、健全规章制度和监管手段、提高责任意识和守法意识三方面提出欺诈行为治理的对策,维护生育保险基金安全运行。

At present,China's maternity insurance fraud cases occur frequently,and the fraudulent be-havior presents the characteristics of diverse subjects and diverse means.Based on the fraud triangle theo-ry,the article found that the pressure faced by the subjects is the external causes of fraud,information a-symmetry,inadequate systems,low regulatory effectiveness for the implementation make room for the fraud.While the greedy mentality,herd mentality,fluke mind and other self-rationalization attitude are the internal causes of fraud.Therefore,countermeasures and suggestions for the management of fraudu-lent behavior are proposed in three aspects:reducing the pressure on the main parties,improving the regu-lations and supervisory means,and raising the awareness of responsibility and law-abidingness,so as to safeguard the maternity insurance fund.