摘要
文章在对个人账户的功能与问题进行理论分析和文献综述的基础上,明确定位个人账户问题的实质是公平与效率问题,并利用实际数据进行分析。得出的主要结论是:从名义筹资负担比率和实际筹资负担比率来看,个人账户的筹资不公平;是否弱化个人账户功能对医疗服务利用公平性影响不大;但弱化个人账户功能有利于统筹基金的平衡运行;而在填补统筹基金缺口方面,相对于降低单位缴费划入个人账户的比例和提高个人自付比例,取消个人账户是更优的政策调整方案。因此,作者建议,应逐渐弱化并取消医保个人账户,并通过扩大个人账户使用范围、完善普通门诊统筹制度、加强社区医疗卫生服务建设等方式来实现从弱化到取消个人账户的过渡。
Based on the policy change analysis of the medical saving account(MSAs) of the three sample cities in Guangdong province,we study the problem of MSA's equity and efficiency by using the actual data.The major conclusions are: in the terms of normal and real financing-burden ratios,the MSA's financing is lack of fairness;whether weakening the function of the MSA or not has little effect on equity of health service utilization,but weakening the function of the MSA is beneficial to social pool funds.To close up the existed funding gap,terminating the MSA is better than other adjustment measure such as increasing out-of-pocket deduction.Therefore we suggest gradually weakening the MSA and then terminating it.This goal should be realized by expanding the MSA's usage scope,improving the patient's co-payment scheme and enhancing the community health services.
出处
《中国人口科学》
CSSCI
北大核心
2011年第5期75-84,112,共10页
Chinese Journal of Population Science
基金
国家社会科学基金重大项目<新时期中国民生保障体系建设研究>(10zd&038)
国家社科基金重点项目<中国医疗保障体系的制度整合与可持续发展研究>(09AZD039)的研究成果
