基于城乡一体化的我国社会医疗保险制度创新研究

我国现阶段＂三分式＂即制度分设、管理体制分治和管理经办资源分散社会医疗保险制度,内在的＂六难＂即制度碎片化难以衔接;制度漏洞难以修补;多重参保难以避免;逆向选择难以克服;道德风险难以规避;管理成本高效率确难以提高等日渐凸显。顺应城乡一体化大趋势,借鉴国际经验,创新我国社会医疗保险制度已迫在眉睫。实行职工连带家属参保;组建基本医疗保险有限责任公司实现政事分开等;业已成为建立城乡一体化社会医疗保险制度的必由之路。

小议加强社会医疗保险数据质量工作的意义

商业保险公司承保的社会医疗保险关系着每一个参保人的医疗保障,而社会医疗保险数据质量则是保证参保人根本利益的前提条件。因此,需要重视加强社会医疗保险数据质量工作,并通过有效的工作方式提高数据质量,使其发挥出社会医疗保险的意义。在大数据时代,社会医疗保险数据质量的相关工作,可以利用大数据的优势优化工作流程、减轻工作负担,并提高工作质量。

德国的法定医疗保险

德国在1883年制定了《工人疾病保险法》,是世界上最早建立医疗保险制度的国家,实行以法定医疗保险(强制)为主,以私人保险(自愿)为辅的医疗保险体系。德国人口约8200万,其中7000万人参加了法定医疗保险,约占总人口的85%。

The Status Quo of and Development Strategies for Healthcare Towns Against the Background of Aging Population

In consideration of elderly peopled need for healthcare in the context of aging population, authois of this paper stxidied tiie combination 〇 ￡ characteristic towns and the healthcare industry against the background, of a vigorous campaign for chafacteristic town construction. In addition to studying thevalue and status quo of healthcare towns, they put forward development strategies for healthcare towns in terms of the health industry, health preservation, eldercare, and vacationing, with a view to injecting new vitality into the construction of healthcare towns.

The Pattern of Government Health Expenditure in China

For a while since the inception of economic system reform programs in 1980s,China's government investment in health was weakened.This resulted in healthcare provider's increasing reliance on user charges for their income,poorer access to healthcare for the vulnerable population groups,and increasing socioeconomic disparities in health and healthcare.To address these problems,China initiated a series of health sector reforms since late 1990s.Our comprehensive review study has found that indeed Chinese government spending on health has been increasing in recent years,especially since 2009,when the new Healthcare Reform Plan was announced.Still,China needs to both further strengthen government investment in health and address the structural imbalances in government health financing,in order to make the overall Chinese health system more equitable and more efficient.

Research on social medical insurance of migrant workers --A case of Suqian city in Jiangsu province

City migrant workers, as one part of the city＇s development, economic development and other aspects of urban to make a great contribution, but the delay with the local residents do not enjoy the same level of medical care treatment is always blocked in outside the city＇s health care system, have less relevant departments, there is no practical system introduced regulations and policies, these things tell us to pay attention to the people, and the introduction of appropriate medical insurance of migrant workers possibly things, and timely medical security system of such groups and the local people medical protection for long support. Make medical insurance system can cities try it＇s best to help foreign workers Medicare, Medicare for the development of China has made a modest contribution.

Reference of retirement system in developed country from the Chinese pension system constitutes

The Chinese government attaches great importance to the social security system, and makes it as an important pillar of socialist market economic system. Especially in the last decade, we seize the sustained, rapid and healthy development of the favorable opportunity of the construction of social security system; we have made unremitting efforts and achieved important progress. After years of exploration and practice, we have a clear basic principles of the social security system and the overall objectives and major tasks, we also established social pooling and individual accounts of the basic old-age insurance, basic medical insurance system, covering pension, medical, unemployment, work injury and maternity insurance, the urban minimum living security system and the framework of the social security system basically forms. The coverage of social insurance continuously expands social security funds which are through nmltiple channels to raise the initial formation mechanism forms, the level of protection continuously improves, and management and service system also gradually improves. The social security system＇ s reform and development plays a very important role in ensuring the basic livelihood of the people, the state-owned enterprise reform, and the smooth progress of economic restructuring.

＂Don＇t Break Your Caregiver＂ Campaign 2011 by Tehy--The Union of Health and Social Care Professionals

According to several researches and survey findings, violence and the threat of violence are increasingly present at workplaces in the field of healthcare. In 2011, the Finnish Union of Health and Social Care Professionals--Tehy implemented a poster campaign targeted at the users of healthcare services, as well as healthcare staff. Representatives of local trade unions, as well as safety representatives, reported that the campaign was relevant. Most employers had a favorable attitude toward distributing campaign posters at the workplace. Raising this issue, which increases the mental burden of work and risks occupational safety at the workplace, helps to achieve improvements. Following the poster campaign, Tehy conducted an electronic survey in early 2012 about the impacts of the campaign among representatives of local trade unions （N= 279） and safety representatives （N = 278）. The campaign resulted in some working environment improvements, as well as an increase in reporting situations involving violence. On a more worrying note, the provision of workplace-level training on managing violent situations did not increase.

The role of government in the mode of ＂medical care and support＂

Along with the acceleration of population aging process, the government as a social security gatekeeper responsibility has become increasingly prominent, improve public finance policy, properly solve the pension problem has become the important work of governments at all levels. Under the guidance of national policy, the State Council ＂on promoting health and pension services combined guidance＂ put forward to 2020, the medical and health care services and resources to achieve the ordered shared, covering urban and rural areas, appropriate scale.functional^reasonable.comprehensive and continuous medical support with service network is basically formed. In this paper, the background of the aging population, the interpretation of the meaning of the combination of medical and support, analysis of the combination of medical support mode. It is pointed out that in public finance from the perspective of medical support with the development mode will face the difficulty of system design is not sufficient, the division of responsibilities is unknown, limitations of existing policies, human, financial and material resources lack of. At last on the basis of the proposed development of medical support combined with the pension service model emphasizes the role of the govenunent to speed up the system construction and innovation of financial subsidies. improve the policy system and other measures.

The Chinese Dream of a More Progressive Welfare State： Progress and Challenges

＂The Chinese Dream＂ and its ideational precursors in official discourse touch upon issues of social policymaking. More specifically, official China has stated the goal of achieving a ＂moderate＂ or ＂appropriate＂ universal welfare state in order to mitigate increasing inequality and the individualization of social risk. Consequently, the new millennium witnessed a wave of social reforms in China's Mainland, the most significant of which were arguably within the policy fields of health insurance, pensions and unemployment protection. This paper reviews reform efforts within these three policy fields and discusses progress and looming challenges with the concept of universalism as the yardstick. From the perspective of universalism, the social right dimensions of coverage （the share of the population included）, generosity （benefit levels or adequacy of welfare proved for those included） and financing （such as state, contributions or private） are quintessential. Coverage of social protection has increased significantly with new schemes in all three policy fields. The hukou divide in coverage of social insurance is not as pronounced as before, especially in health insurance. However, major challenges still persist. Declining benefit generosity or adequacy has been a tendency in both pensions and unemployment protection. The pension system also faces problems of financial fragmentation and unsustainability. The health insurance system is still inadequate in terms of protection against health risks, particularly serious or chronic illnesses. These issues are more pronounced in schemes catering to rural residents or urban residents outside the labor market. This reflects that schemes for urban workers are still much more generous. In this regard, recent tentative efforts to integrate the divided welfare system should be noted.