国外医疗保险制度模式及其对我国的启示

沈阳理工大学

毕业设计（论文）

题目：国外医疗保险制度模式及其对我国的启

示

摘要

医疗保险是社会保障制度的重要组成部分，是各项社会保险制度中最复杂的一项，被称为“世界性难题"。医疗保险制度改革是一项复杂的社会系统工程，关系改革、发展、稳定的大局。由于涉及多方利益格局的调整，人们对其关注程度远远超过了其他问题。医疗保障制度总的来说有国家医疗保险模式、社会医疗保险模式、商业医疗保险模式和储蓄医疗保险模式四种典型模式，这几种模式各有利弊。我国的医疗保险制度也经历了两个时期——国家医疗保险和社会医疗保险，现已初步建立起社会统筹和个人账户相结合的城镇职工基本医疗保险制度和新型农村医疗合作制度。但是，同养老、失业保险相比，医疗保险制度的改革步履为艰，我国目前现行医疗保险体系尚不能实现全民医保，应当采取有效措施进行改进。本文分析了当前国内外社会医疗保险制度的历史沿革及发展背景，着眼于我国城镇医疗保险改革的现状，总结了国外医疗保险制度运行的成功经验和教训，根据当前的国情提出了完善我国医疗保险制度的对策建议。

关键词：医疗保险制度，模式，启示，医疗保障

Abstract

Medical care insurance is an important component of social guarantee system，it is also the complicated item among various insurance systems. So it is called ‘international problem’. The reform of medical care insurance is a complex social systematic project, which is closely related the general situation of reform, development and stability. People are paying much more attention to this problem than to others，because it involves the adjustment of multilateral benefits．Looking at the insurance mode worldwide it general has four typical patterns including national health insurance mode, social health insurance mode, commercial health insurance mode, and savings insurance mode, each has both advantages and disadvantages. After experienced two periods of the national health insurance and social health insurance, the basic medical care insurance system which combines society’s balance and personal account in cities and towns and the new rural cooperative medical system in village in China have just begun. However, it still has a hard and long way to go compared with old-age pension and unemployment insurance.Beginning from the revolution and background of present urban medical care insurance system of both domestic and abroad, the thesis analyses the present situation of medical care insurance reform, and generalizes a series of successful experience and failure lessons of medical care insurance system from abroad. According to our national situation, the thesis propose a policy to perfect the urban medical care insurance system．

Keywords: system of medical care insurance, mode, enlightenment, medical security

目录

摘要.............................................................. I Abstract.......................................................... I II 引言 (1)

1 医疗保险制度概述 (2)

1.1 医疗保险制度的概念及内容 (2)

1.1.1医疗保险制度的概念 (2)

1.1.2医疗保险制度的基本内容 (2)

1.2 医疗保险制度的理论综述 (2)

2 国外医疗保险制度模式及经验介绍 (4)

2.1 国外医疗保险模式特点 (4)

2.2.1以英国为代表的国家医疗保险模式 (4)

2.2.2以德国为代表的社会医疗保险模式 (4)

2.2.3以美国为代表的商业医疗保险模式 (5)

2.2.4以新加坡为代表的储蓄医疗保险模式 (5)

2.2 国外医疗保险制度模式的主要问题及改革方向 (6)

2.2.1国外医疗保险的主要问题................. 错误!未定义书签。

2.2.2国外医疗保险的改革方向................. 错误!未定义书签。

3 我国医疗保险制度现状分析 (9)

3.1 我国医疗保险制度的发展及演变 (9)

3.1.1城镇职工基本医疗保险模式 (9)

3.1.2新型农村医疗合作模式 (9)

3.2 以辽宁省为例分析我国医疗保险制度存在的问题 (10)

3.2.1医疗保险覆盖面不全 (10)

3.2.2医疗保险费用增长过快 (11)

3.2.3保险基金筹措不公平 (12)

3.2.4医药卫生配套体制不完善 (12)

4 国外医疗保险制度对我国的启示 (13)