Reflections on the Fairness of Connection Mechanism Between the Financing and Benefits of Residents' Medical Insurance in China
The 14th Five-Year Plan for National Healthcare Security proposes one of the goals of China's medical security industry is to build fair medical insurance.A fair and unified social healthcare security system can narrow the differences in medical benefits,medical resources,and health status between regions and groups,enhance the sense of fairness and happiness of all urban and rural residents,and play an important role in promoting common prosperity.On the basis of combining the principle of"income according to expenditure"in fund-raising with the principle of"expenditure according to income"in benefits payment,and achieving overall income and expenditure balance,this article uses the cost estimation model and rough estimation method in the medical insurance fund-raising model to calculate the compatibility between fund-raising and benefits,as well as the fund income and expenditure,for eight administrative regions that achieve provincial pooling of resident medical insurance.It was found that the overall matching between fund-raising and benefits in the eight administrative regions is poor,which does not conform to the consistency and fairness of premium payment and benefits guarantee.The following suggestions for improvement are proposed such as exploring the gradual shift of fund management principles towards"income according to expenditure",improving the dynamic adjustment mechanism for standards of premium payment and benefits,and strengthening the connection between fund-raising and benefits,continuously promoting provincial coordination of medical insurance,clarifying the scope and boundaries of benefits guarantee,etc.
resident medical insurancefund-raising levelpayment of benefitsincome according to expenditure
万方数据
维普
