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大学生医疗保障现状分析与制度创新--基于厦门大学的实证分析
时间:2011-02-01 浏览次数:1325次 无忧论文网
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社会保障
医疗保障医疗保障
    在十届全国人大五次会议上,温家宝总理已经宣布,今年要启动城镇居民医疗保险改革试点,并计划在“十一五”期间,基本实现这项制度。这标志着我国城镇职工医疗保险将向城镇居民延伸。大学生群体作为特殊的一类城镇居民,其医疗保障仍是低水平的公费医疗,而且这项制度的弊端日益突显,越来越难以保障大学生的基本健康权益。然而,目前针对大学生医疗保障改革的基本思路还不明朗,具体的方案也仅在个别地区试行,并且没有形成较为统一的政策,例如镇江实行的是学生合作医疗保险,上海则将大学生的医疗保障由原来的学校保障转型为社会保障。因此,在城镇居民医疗保险和农村新型合作医疗快速推进的情况下,加快大学生医疗保障制度的改革已成“倒逼”之势。本文结合厦门大学的调研资料,分析了目前大学生医疗卫生服务的供求情况和医疗保障的现状,提出基本的解决思路和政策建议,旨在建立一种能够有效保障大学生切身利益的医疗保障制度。全文共分为五部分:
    第一部分:引言。介绍问题的提出、研究的内容和方法。
    第二部分:大学生医疗卫生服务的基本情况。医疗卫生服务是建立医疗保障的基础。这部分主要从两个方面进行研究探讨:一是分析大学生医疗卫生服务的供给情况,主要从资金供给和机构供给两方面进行分析;二是分析大学生医疗卫生服务的需求情况,利用调查问卷获取的资料,从影响需求的因素、医疗卫生服务的利用情况、医疗消费的特殊性等方面进行分析研究。
    第三部分:大学生医疗保障现状描述与问题分析。目前,我国大学生医疗保障既有正式的制度安排,比如,公费医疗、商业健康保险;也存在一些非正式供给,比如家庭保障、爱心募捐。这部分主要分析了目前大学生医疗保障的实行情况、存在问题、发展障碍等。
    第四部分:大学生医疗保障制度重构。力图在以上分析研究的基础上,结合大学生医疗消费和医疗保障的现实情况,通过将大学生医疗保障纳入国家社会保障计划,建立保险模式的医疗保障,以重构大学生医疗保障制度。
    第五部分:结语。总结大学生医疗保障制度要实现的转变。 [英文摘要]:     At the fifth session of the tenth NPC, Premier Wen Jiabao already announced that it was to start the reform of medical insurance for urban residents in this year, and plan to realize this system basically during the Eleventh Five-Year Plan period. It marks that the system of medical insurance for urban workers will extend to urban residents. The college students as the peculiar urban residents, whose medical security still is the low-level public health services, and the abuse of this system is increasingly prominent, which is more and more difficult to ensure the basic healthy rights of college students. However, at present the fundamental thoughts for reforming the system of medical security for college students is not clear, and the concrete schemes only try out in some areas, which do not form comparatively unified policy, for instance, Zhenjiang practises the pupillary cooperative medical insurance; Shanghai transforms the medical security for college students from original school security to social security. Therefore, reformation of the medical security for college students is the first imperative, under the situation that the medical insurance for urban residents and rural cooperative medical system pushed on at a rapid pace. This paper analyzes the relationship between the supply and demand of health service for college students and the current situation of medical security for college students with the investigation data of Xiamen University, and formulates a comprehensive policy program in order to establish medical security system conducive to college students’ health and development. This paper falls into five sections:
    Part I: Introduction. This part introduces the issues, contents and ways of research.
    Part II: Basic situation of health service for college students. Health service is the foundation of establishing medical security system, its relationship between the supply and demand directly impacts the establishment of medical security for college students. This part carries out investigation and discussion mainly in two aspects. On the one hand, it analyses the supply of health service for college students from money supply and organization supply; On the other hand, it analyses the demand of health service for college students with data of questionnaire.
    Part III: Current situation description and problems analysis of medical security for college students. At present, there not only formal systems of medical security for college students but also a few informal supplies in China, this part mainly analyses the current situation, problems and the obstacles to the development of medical security for college students.
    Part IV: System reconstruction of medical security for college students. Based on the above analysis, this part formulates a comprehensive policy program which integrates the medical security for college students in the overall social security plan, and establishes the medical security for college students with insurance mode.
    Part V: Conclusions. This part summarizes some transformations that the system should realize.    
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