福建医科大学学报(社会科学版)2024,Vol.25Issue(1) :43-48.

生育保险欺诈行为分析及对策

Analysis of maternity insurance fraud and suggestions for countermeasures

叶向阳 李跃平
福建医科大学学报(社会科学版)2024,Vol.25Issue(1) :43-48.

生育保险欺诈行为分析及对策

Analysis of maternity insurance fraud and suggestions for countermeasures

叶向阳 1李跃平2
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作者信息

  • 1. 福建医科大学卫生管理学院,福建 福州 350122
  • 2. 福建医科大学图书馆,福建 福州 350122
  • 折叠

摘要

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.

Abstract

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.

关键词

生育保险/舞弊三角理论/反欺诈

Key words

maternity insurance/fraud triangle theory/anti-fraud

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出版年

2024
福建医科大学学报(社会科学版)
福建医科大学

福建医科大学学报(社会科学版)

CHSSCD
影响因子:0.639
ISSN:1009-4784
参考文献量25
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