从形式公平到实质公平:居民医保城乡统筹驱动路径反思

发布时间：2018-04-30 23:16

本文选题：医疗保险 + 城乡统筹　；参考：《社会保障研究》2016年01期

【摘要】：医疗保险的城乡统筹,是基于制度公平的理念、完善全民医保制度建设、推进基本公共服务均等化的重要内容。但是,由于缺乏顶层设计和正义理念的引导,当前阶段全国各地探索推进的居民医保城乡统筹,一直是各地根据自下而上、自主探索形成的,在行政管理体制、制度模式设计以及经办服务三方面的统筹上,形成了多样化的格局且有进一步扩大差异的趋势。本文从行政管理和公共政策实践效果比较的视角,对全国居民医保城乡统筹格局现状、驱动路径、分布特点、一般规律进行归纳梳理。研究发现,由于缺乏全国层面制度顶层设计,各地的统筹进展以地方行政力量推动为主,不同的驱动力量影响着制度模式和经办服务的选择,追求的形式公平大于实质公平。新时期的居民医保城乡统筹,迫切需要加强顶层设计,强化公平正义理念,向追求实质公平转变。
[Abstract]:The urban and rural planning of medical insurance is an important content of perfecting the construction of universal medical insurance system and promoting the equalization of basic public services based on the concept of institutional fairness. However, due to the lack of top-level design and the guidance of the concept of justice, at the present stage, the residents' medical insurance system, which is being explored and promoted throughout the country at this stage, has always been formed in the administrative system according to bottom-up and self-exploration. The design of the system mode and the coordination of the three aspects of administration and service have formed a diversified pattern and have the tendency of further enlarging the difference. From the perspective of comparing the effect of administrative management and public policy, this paper sums up the current situation, driving path, distribution characteristics and general law of urban and rural overall planning pattern of residents' medical insurance in China. It is found that due to the lack of the top-level design of the national system, the overall progress in various places is mainly driven by the local administrative forces. Different driving forces affect the choice of institutional models and operational services, and the pursuit of formal equity is greater than substantive fairness. In the new period, it is urgent to strengthen the top-level design, strengthen the concept of fairness and justice, and change to the pursuit of substantive fairness.
【作者单位】：贵州财经大学公共管理学院;中国人民大学劳动人事学院;
【分类号】：F842.684

【相似文献】