人口与经济

我国医疗筹资的公平性研究—基于"中国健康与营养调查"的微观数据

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作者：牟俊霖

单位：首都经济贸易大学劳动经济学院, 北京 100070

关键词：医疗筹资;公平性;Kakwani指数;集中指数

分类号：F840.684

出版年,卷(期):页码：2010,31(6):47-53

摘要：

文章运用Kakwani指数、集中指数测算了医疗筹资的公平性。结果表明:自付医疗支出是最主要的筹资形式,医疗保险筹资比重很小,提高医疗保险筹资比重是改革的重点。从医疗筹资的公平性来看,自付医疗支出和保险筹资都具有较强的累退性,而我国的医疗补贴却具有较强的累进性,我国的医疗筹资体系发挥了"劫贫济富"的逆向作用。在农村,提高合作医疗的筹资比重是重点;在城市,提高职工医疗保险的公平性是重点。

Basing on the analysis of the composing of health care financing, the equality of health care financing is calculated using the Kakwani index and concentration index.The analysis shows that the outof- pocket payment is the far more important than health care insurance, and both are degressive.On the other hand, health care subsidies are concentrated on rich people and the poor people receive less subsidy.In a word, the poor people subsidize the rich people in our health care financing system.It is important to improve the financing ratio of cooperative insurance in rural area, while it is urgent to improve the equality of service and worker insurance in urban area.

基金项目：

作者简介：

牟俊霖(1979-),四川荣县人,首都经贸大学劳动经济学院讲师,经济学博士,研究方向为劳动就业和医疗保险

参考文献：

[1] 世界卫生组织. 2000年世界卫生报告:卫生系统:改进业绩[R]. 北京:人民卫生出版社,2000. 93.
[2] Wagstaff A. and Van Doorslaer. Equity in the Delivery of Health Care:Some International Comparisons[J]. Journal of Health Economics,1992,(11).
[3] Van Doorslaer and Wagstaff. The Redistributive Effect of Health Care Finance in Twelve OECD Countries[J]. Journal of Health Economics,1999,(18).
[4] Wagstaff A. Measuring Equity in Health Care Financing-reflections on (and alternatives to) the World Health Organization's Fairness of Financing Index[R]. The World Bank,Policy Research Working Paper Series 2550,2001.
[5] Wagstaff A. and Van Doorslaer. Equity in the Delivery of Health Care:Some Tentative Cross-country Comparisons[J]. Oxford Review of Economic Policy,1989,5(1).
[6] 贺鹭,郑建中,韩颖. 山西省新型农村合作医疗家庭筹资公平性分析[J]. 中国农村卫生事业管理,2006,26(11).
[7] 王晶. 中国农村医疗筹资公平性研究—基于全国八个农业县医疗筹资系统的实证研究[J]. 社会学研究,2008,(5).
[8] 魏众,B. 古斯塔夫森. 中国居民医疗支出不公平性分析[J]. 经济研究,2005,(12).

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