山西省城镇居民基本医疗保险制度供需研究.pdf

山西财经大学
硕士学位论文
山西省城镇居民基本医疗保险制度供需研究
姓名:张琪
申请学位级别:硕士
专业:社会保障
指导教师:白凤峥
2011-03-16
摘要

为实现基本建立覆盖城乡全体居民的医疗保障体系的目标,2007 年我国启
动了 79 个城镇居民基本医疗保险试点工作。截止到 2009 年底,山西省 11 个
试点城市全部启动了城镇居民基本医疗保险。
结合社会医疗保险的相关理论,本文以山西省医疗保险管理服务中心的资
料数据为基础,介绍了山西省城镇居民基本医疗保险试点工作开展 3 年多来的
实施成效,分析总结了城镇居民基本医疗保险制度在运行过程中出现的问题。
本文主要从影响山西省城镇居民基本医疗保险的需求与供给的主要因素入手
进行分析研究,人们对健康的追求及疾病的风险,参加城镇居民医疗保险的人
数不断攀升,人均可支配收入的逐步提高以及医疗服务价格的影响,均会增加
居民对城镇居民医疗保险的需求;山西省社会经济的发展、城镇居民医疗保险
的承保能力、政府财政补助、社会医疗服务体系建设情况共同构成了影响城镇
居民基本医疗保险的供给因素。针对相关医疗保障制度的衔接问题与参保需求
者间的矛盾;保障水平与居民的医疗消费需求之间存在差距;试点工作配备人
员少、经费不足,无法满足快速增长的参保居民服务需求等问题,从加强政府
部门责任、开拓社会筹集渠道、提高居民的正确认识等几个方面提出相应的政
策建议,解决供需双方的矛盾,提高制度的可及性及可持续性,满足城镇居民
的医疗需求。

【关键词】城镇居民基本医疗保险供给方需求方

3
Abstract

To achieve the target of setting up the basic urban and rural medical security system, Chinese
government established the pilot work of basic medical insurance in cities and towns in 2007. The
basic medical insurance for urban residents launched by all 11 pilot cities in Shanxi Province has
made great achievements but also exposed some problems, by the end of 2009.
This paper reviews the related theories on the social medical treatment insurance, based on
the data of materials provided by Medical Insurance Management Service Center of Shanxi
Province, this paper introduces 3 years` implementation of pilots of the basic medical insurance
system for urban residents, and this paper analyses and summarizes the operational problems of
the urban resident basic medical insurance system. Those operational problems may caused by
lots of reasons, the paper mainly analyses the main influencing factors of demands and supplies of
the basic medical insurance for urban residents. People's pursuit of health, disease risk, the rising
amounts of participating the urban resident medical insurance, the gradual improvement of the per
capita disposable e and the prices of medical service, all can increase residents' needs on
urban medic